Ohio Bucket Brigade Take back your air The 'bucket brigade' is a simple but effective sampling tool citizens are using to find out for themselves what chemicals are in the air. Armed with our own data, we can win reductions of pollution and enforcement of environmental laws. Shelly Asphalt, Westerville Pollution complaints log Name ___________________________ Address _____________________________________ Telephone ______________________ Email _______________________________ Date _____________, 2004         Time started _________ Time ended _______________ Source __________________________ Wind direction __________

I see Smoke Flare Toxic cloud Fire Explosion Dust Other: Please describe _____________________________________________________ _____________________________________________________ I smell Rotten eggs Gasoline Heavy oil Sweet Sour Bitter Other: Please describe _______________________________________________________ _______________________________________________________ I feel Burning eyes Nose/throat irritation Breathing problems Skin irritation Other: Please describe _________________________________________________________ _________________________________________________________

Please print this form, complete it and mail to -- Ohio Citizen Action, Attn: Simona 3400 North High Street, Suite 430 Columbus 43202 Or fax to (614) 263-4540. When you smell the odor, please call --

Shelly Asphalt complaint number Larry Shively, Vice President (740) 246-5009 Ohio EPA air complaint number Todd Scarborough (614) 728-3813       Other important numbers     Your Bucket Brigade coordinators Bobbi Jo and Bob Hoak (614) 895-2106 Ohio Citizen Action Simona Vaclavikova (614) 263-4111 Your local press John Sheridan, News and Public Opinion (614) 410-1379   Liz Pecek, This Week (614) 841-1781