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San Joaquin County <br /> Environmental Health Department <br /> 1868 E Hazelton Avenue, Stockton, CA 95205 <br /> (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br /> Instruction <br /> 1. Date waste was transported. <br /> 2. Tracking/ complaint number. <br /> 3. Time of day waste is transported. <br /> 4. EPA ID number-already filled out. <br /> 5. San Joaquin County EHD Transporters Registration number—already filled out. <br /> 6• Agency reporting the illegal dumping. <br /> 7. Location waste is transported from. <br /> 8. Drop off location—already filled out. <br /> 9. The number of items(filled out), quantity and size of container. <br /> 10. Waste description—name (if possible), physical state, other description. <br /> 11. Emergency contact—already filled out. <br /> 12. Include any special handling or storage information to assist anyone handling the waste. <br /> 13. Signature of inspector transporting the waste. <br /> 14. Name of inspector. <br /> 15. Title of inspector. <br />