HILLSIDE AVENUE - RODENT COMPLAINT (2) 4oNWt:';
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 LRAMDIN SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: __ Received By: ,
Complaint Number: 2180
Complainant
Address: Phone:
Investigated By: Date:
Property Owner/Occupant Name Telephone #: