Appendix C-4: Sample Pollution Log In the sample pollution log below, instructions are in bolded green text to indicate where you need to add information. You can copy and paste the sample log below or download the editable sample log. Download the Sample Pollution Log SAMPLE POLLUTION LOG Name: [Insert your name] Date: [Insert the date] Address: [Insert address where pollution observed] What did you observe? [Insert brief description of the pollution observed] Did anyone else observe this? [List any other observers] For how long did you personally observe this activity? [Insert duration problem was observed] Did the activity continue after you stopped observing it? For how long? [Insert duration of activity] Do you think this activity poses a health risk to you or your community? YES / NO Why? [Insert brief explanation for why the activity poses a health risk] Facility Name: [Insert facility information] Address: [Insert facility address] Observer Date & Time Location Visible Amount Duration Notes Action Taken More from the EJ Green Book Appendix B: Contact Information A list of addresses, phone numbers, websites and email addresses of government agencies, community interest groups, health clinics, and... Appendix A: Legal Resources A list of helpful website links for legal resources - including legal representation, laws, and case rulings. How Environmental Laws and Tools Can Help Your Community Outlines the first steps for addressing environmental issues with laws and tools provided in the Green Book. Understanding Grassroots Organizing Recommendations and guidance for effective community organizing. Knowing What’s In Your Neighborhood A starting point for identifying potential environmental burdens in your neighborhood with a list of helpful websites and resources. Protecting Your Community: Getting Started A brief guide to help you protect your community and a road map for how to utilize the information... Where You Live Affects Your Health Detailing environmental impacts on health, common pollutants, and why not all communities have the same environmental conditions. Understanding Legal References An overview of legal references and terms used environmental law and in the EJ Green Book.