10 Linden Street Complaint 2-6-2019 iiau�r,�.
' CITY OF SALEM, MASSACHUSETTS
,��: 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 a SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: ` Received By: .
Complaint Number: 2348
Complainant jaur-�
Address: Phone: e '
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Investigated By: Date:
Property Owner/Occupant Name Telephone #: