CIRCLE HILL ROAD - RODENT COMPLAINT 4.
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4"H FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS%REIIS,CHO,CP-FS LRAMDIN -SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time:
; _7n Received By: i 2S
Complaint Number: 1768
Complainant S
Address: Phone:
lur ,
Investigated By: Date:
Property Owner/Occupant Name Telephone #: