73 FLINT STREET - OVERGROWTH, TRASH, RODENT COMPLAINT Lai m� CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4:"FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINnSALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By:
Complaint Number: 2244
Complainant Yi s/) f ri J)
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Address: ` � ?//� Phone:
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Investigated By: Date:
Property Owner/Occupant Name Telephone #: