20 Park Street Complaint 8-28-2019 � �. CITY OF SALEM, MASSACHUSETTS
._�'� BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,,f"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: 2556
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