8 and 22 Osborne Street Complaint 12-5-2017 CITY OF SALEM,, MASSACHUSETTS
a, BOARD OF HEALTH
KIMBERLEY DRISCOIL 120 WASHINGTON STREET,4"FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDEN,RS/REHS,CHO,CP-FS LRAMDN(q,1SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
V11
Date: Time: Received By:
Complaint Number:.2021
Complainant In P.),P,
Address: Phone:
Ap
Investigated By: Date:
Property Owner/Occupant Name Telephone#: