324 Bed Bug Complaint I
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Date: 9h TIIne:
Name of Complainant:
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Map:
iRz
Address:
s,.* au Ho„s2 32L1
Parcel:
NATURE OF',COMPLAINT:
sca
Looation:
Owner
Address:
Tel:
Taken by:
Date of Inspection: ITime:
INSPECTOR'S REPORT:
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Hits
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Action Taken:
cc.11*d Sal '� N 01(1( ur.
Inspector Signature
02-esu Ifi or