39 Endicott Street #8 Complaint 8-26-2019 R k ? CITY OF SALEM, MASSACHUSETTS
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BOARD OF HEALTH
KIMBERLEY DRISCOLL 1.20 WASHINGTON STREET,41H FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDrN a SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: 3 Received By: Ij S
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Complaint Number: 2554
Complainant
Address: 3 -1 Eynd I o-f j S-k�+ UM Phone:_,33 — �Y®--&am
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Investigated By: Date:
Property Owner/Occupant Name Telephone#: