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11-13 Read Street Complaint 12-8-2017 NhM R CITY,OF SALEMI, MASSACHUSETTS 3� BOARD OF HEALTH KIMBERLEY DRISCOLI. 120 WASHINGTON STREET,4TH FLOOR { MAYOR TEL.(978)741-1800 FAx(978)745-0343 LARRY RAMDTN,RS/REHS,CHO,CP-FS LRAMDIN a+SALEM.COM, HEALTH AGENT COMPLAINT INTAKE FORM �"✓i' Date: Time: Received By: Complaint Number: 2024 � � r Complainant ' ' [' Address: - Phone:_�� =��. ,r r - - - = -- - 14 - - 1/9 = - - - - r -� - -� - -- Investigated By: ----------------- -------- Date: ---- -- ---------.. Property Owner/Occupant.Name______ .__—____._____—____'Telephone#: _ _