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L � � <br /> LSurface/Subsurface Contamination Report Checklist <br /> NOA Project Number: E04145A <br /> Page 4 <br /> L 13. a.Are there any open or damaged containers containing unidentified substances observed on the subject <br /> property? <br /> Yes Q No <br /> I <br /> ` b.Within 250 feet? <br /> Yes Q No [in None observed <br /> v <br /> 14. Identify anq surface waters within 1,000 feet.of the subject property <br /> Wetland located to the northwest of the subject property <br /> 16. a. Identify the potable water supply source: <br /> BPublic Water System M Other Agricultural well at northwest corner ofpropero <br /> Private Well ®None <br /> v <br /> b. Is there observed evidence of a private well within 1,000 feet? <br /> Yes[Z] NoE3 Agncultural well on ad aceni pmperty to north,domestic wells most hkeyalso present <br /> 17. Identify the sewage disposal system: <br /> Public Sewer System M Other <br /> On-site septic system m None <br /> ` <br /> is. Are there any pits,ponds,or lagoons located on the property in connection with waste treatment or waste <br /> disposal? <br /> Yes Q No [Z] Agricultural pond at southwest corner of subjectproperty <br /> L' 19. a.Is there evidence that the subject property discharges waste water,other than storm water,directly into a <br /> ditch or stream on or adjacent to the property? <br /> I <br /> Yes Q No <br /> 1 <br /> Lb.Any discharges observed within 200 feet? <br /> Yes No None observed <br /> "44L <br /> L <br />