Trash Complaint 2009 BOARD OF HEALTH
CITY HALL
COMPLAINT RECORD
Date: 3-3 -0`) I Time:
Map:
Name of Complainant: $.11 Lt.fehcLcn'
Address: ��
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��, NATURE OF COMPLAINT:
ILK (Y U en n4/0 --Ps 'l /h.h •P wri ,2
°J LII fisvr out-) /
Mori IMo5l t
IParcel:
Tel:
n e5t-
Location:
Owner:
Address:
Taken by:
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C*JCfier4 2€L y L nj -0„s
12.extve. (flreCa-£ 3AT,c Z C reox, o2..fs>e4 -
I Tel:
1 Date of Inspection: I Time:
INSPECTOR'S REPORT:
Action T
Inspector Signature
o„ital Pholorsl Taken
Cheek E,I
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