Salem Heights Pope Street Complaint 2-25-2019 n mt d
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4T'FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMD1Nrt1 SALEM.COM
HEALTH AGENT
I(IM
COMPLAINT INTAKE FORM
Date: '� Time: r Received By: .140
Complaint Number: 2366
Complainant
Address: +- I Phone: Jy ,�M
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Investigated By: Date:
Property Owner/Occupant Name-- Telephone#: _
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