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1-0 <br /> Evidence of a private well within 1,000 feet? <br /> None observed <br /> 16. Identify the potable water supply source: <br /> Well <br /> 17. Identify the sewage disposal system: <br /> Septic system <br /> 18. Are there any pits, ponds, or lagoons located on the property in connection with waste <br /> treatment or waste disposal? <br /> No <br /> 19. Is there evidence that the subject property discharges waste water, other than storm <br /> water, directly into a ditch or stream on or adjacent to the property? <br /> No <br /> Any discharges within 200 feet? <br /> None observed <br /> 20. Is there evidence of underground/aboveground storage tanks on the subject property? <br /> No <br /> Within 200 feet? <br /> None observed <br /> ... 21. Are there any vent pipes, fill pipes, or access ways indicating a fill pipe protruding from <br /> the ground on the subject property? <br /> No <br /> Within 200 feet? <br /> None observed <br /> 22. If there is a structure on the subject property, are there any flooring drains or walls <br /> located within the structure which have been stained with a substance other than water <br /> or are emitting foul odors? <br /> N/A <br /> 23. If there is a structure on the subject property, describe its uses and note any presence of <br /> readily apparent asbestos-containing materials (ACM). <br /> 4 <br /> r <br />