BoH Complaint_Submission222_10/28/2019 9:00:35 AM_ Board of Health Complaint form
This form captures submitted complaints for Salem's Board of Health
department to investigate.
Fields with a * are required to be entered. Some fields are greyed
�'��M►niE°� out but will auto populate from other field entries on the same form.
KIMBERLEY DRISCOLL
MAYOR
DAVID GREENBAUM,IRS
HEALTH AGENT
Date* 10/28/2019
9:00:35 AM
Complaint Type* Restaurant/Food
Street Number
Street Name* WASHINGTON STREET
Unit Number 157
Occupant Name
Parcel ID
Inspector Account SALEM\dgreenbaum
Ward M
Land Use
Complainant Josette Gooch
Name*
Complainant Phone 000000000
Number* --
Complainant Email josette.nicole91@gmail.com
Address
Comment:* Mice running around at Passage to India.
CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
98 WASHINGTON STREET,3RD FLOOR
TEL.(978)741-1800
Dgreenbaum@SALEM.COM