159 BRIDGE STREET - HOUSING COMPLAINT (2) n. CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4TH FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS
LRAMDIN(d!SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By:
Complaint Number: 2052
Complainant
Address: Phone:
Investigated By: _ Date:
Property Owner/Occupant Name Telephone #: