OSBORNE STREET - TRASH COMPLAINT s CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,47'FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDTN,RS/REHS,CHO,CP-FS LRAMDTNiu;$ALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
bats: 3 Time: Received By:
Complaint Number: 2257
Complainant
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Investigated By: Date:
Property Owner/Occupant Name Telephone#:
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