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V SSSCR Site Reconnaiasance Checklist <br /> NOA Project Number: E040122A <br /> Page 4 <br /> V <br /> 13. a.Are there any open or damaged containers containing unidentified substances observed on the subject <br /> Property? <br /> ✓r Yes 0 No ® None observed <br /> V b.Within 250 feet? <br /> Yes Q No None observed <br /> L <br /> 14. Identify any surface waters within 1,000 feet.of the subject property <br /> Mormon Slough, cumnty dry, defines the southern property boundary <br /> I& a. Identify the potable water supply souse: <br /> Public Water System ©other Not determined during site wit <br /> Private Well F]None <br /> b. Is there observed evidence of a private well within 1,000 feet? <br /> ) i,,[:] N10[Z] Some surrounding rural residences most likely baveprivate welly <br /> a. <br /> 17. identify the sewage disposal system: <br /> Public Sewer System ®Other Not determined during site visit <br /> r, On-site septic system M None <br /> 18. Am there any pits,ponds,or lagoons located on the property in connection with waste treatment or waste <br /> V disposal? <br /> Yes[—] No <br /> 19. a.Is there evidence that the subject property discharges waste water,other than stoffi water,directly into a <br /> ditch or stream on or adjacent to the property? <br /> L. Yes ED No <br /> L <br /> b.Any discharges observed within 2.00 feet? <br /> LYes Q No ® None absented <br /> L 04 <br /> L <br /> L <br />