10 Linden Street Complaint 10-29-2019 a
CITY OF SALEM MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4Ta FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDIN 7SALEM.COM
HEALTH AGENT
AVA
COMPLAINT INTAKE FORM
Date: �_ Time: Received By: y-
Complaint Number: 2619
Complainant_ _� � ��_ - W�U��� Ike k
Address: i o Phone:
Kad
Investigated By: _ Date:
Property Owner/Occupant Name__ _ Telephone