WALTER STREET - TRASH COMPLAINT CITY OF SALEM,MASSACHUSETTS
'P BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,41H 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: 2220
Complainant
Address: Phone:
Y
IL
Investigated By: Date:
Property Owner/Occupant Name Telephone #: