32 Complaints BOARD OF HEALTH
CITY HALL
COMPLAINT RECORD
Date2.72 ._ Time--
Complainant -- 4
Nature of Complaint 4_a
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Location of Premises
Name of
Tel
Address - —f - 141---;
Aft
Address —
Taken by—______Ilzu&-_-_ _.__ Referred to-
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Date of inspection
INSPECTOR'S REPORT
— ----
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Action Taken Al Ditt- ._,_____
-- ---- —.-----_.-_---- .
Inspector
Cr' �S
Geo Tracking #: z 5 By:
SEPTIC_ HOARDING
WATER/SEWER_ HOUSING NAIL SALONS
3OOD_ SMOKE_ POOLS_
NUISANCE ODOR tESTS_
BODYART-- OTHER
Date Entered: t_j_141_
'OMPLAINT INFORMATION:
;omplaint Location:_
•ature of Complaint:
Date of Complaint:\_/_/—
Animals: YIN l Child Under 6: Y/N
COMPLAINTANT'S FORMATION: Telephone#
Complainant/Occupant's Name: Alternate#
Complainant/Occupant's Address:
OWNER'S INFORMATION:
Owner's Name: 'r
Property Mgr./LL:
Complaint Unfounded:
Conditions Found:
ACTION TAKEN:
Address.
Address:
)0s AA
Telephone#( ) -
Alternate# ( )—
nature of Inspecting Officer
I 1 I 3 /±-F--
Date/Time of htspeetiea
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