52 Peabody Street #1R Complaint 3-13-2019 _ CITY OF SALEM, MASSACHUSETTS
y�`�r BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4"FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS 11
LRAMDIN1 SALEM.COM
HEALTH AGENT � � � r
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COMPLAINT INTAKE FORM
Date: c Time: Received By:V
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Complaint Number: 2375
Complainant
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Investigated By: Date:
Property Owner/Occupant Name Telephone#:
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