3 Ropes Street Complaint 3-20-2019 ; nJ CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4TH FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINQ!SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: _ Time: Z��aC�Gtti, Received By- c
Complaint Num��b`er: 2380
Complainant
Address: Phone:
617 -9 66C7
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Investigated By: _ Date:
Property Owner/Occupant Name Telephone#: