BoH Complaint_Submission1287_12/16/2019 9:11:16 AM_ �ONDIT,� Board of Health Complaint form
This form captures submitted complaints for Salem's Board of Health
department to investigate.
9
�J,p�,�/M►niEoo� Fields with a * are required to be entered. Some fields are greyed
out but will auto populate from other field entries on the same form.
KIMBERLEY DRISCOLL
MAYOR
DAVID GREENBAUM,IRS
HEALTH AGENT
Date* 12/16/2019
9:11:16 AM
Complaint Type* Illegal Dumping
Street Number 22
Street Name* PUTNAM STREET
Unit Number
Occupant Name
Parcel ID
Inspector Account SALEM\Jbarosy
Ward 4
Land Use
Complainant Anonymous
Name*
Complainant Phone Anonymous
Number* A�
Complainant Email
Address
Comment:* Appliance,trash on street in front of garage at 22 Putnam
CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
98 WASHINGTON STREET,3RD FLOOR
TEL.(978)741-1800
Dgreenbaum@SALEM.COM