FIRST STREET - TRASH COMPLAINT (2) a
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 LRAMDINra'SALEM.COM
HEAT.TH AGENT
COMPLAINT INTAKE FORM
Date: - Time: Received By: s
Complaint Number: 2255 _
Complainant
- ` Phone:
Address:.' ' ' 1 N /
Investigated By: Date: -
Property Owner/Occupant Name Telephone #: