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Surface/Subsurface Contamination Report Checklist <br /> NO A Project Number: E05111 A <br /> Page 4 <br /> 13. a.Are there any open or damaged containers containing unidentified substances observed on the subject <br /> property? <br /> Yes 0 No Q <br /> b.Within 250 feet? <br /> Yes[—] No <br /> 14. Identify any surface waters within 1,000 feet.of the subject property <br /> Irrigation ditch directynodh of subject properly <br /> 16. a. Idcntify the potable water supply source: <br /> F7 Public Water System M Other <br /> Private Well �None <br /> b. Is there observed evidence of a private well within 1,000 feet? <br /> Yes 571 No M <br /> l?. Identify the sewage disposal system: <br /> Public Sewer System r7 Other <br /> aOn-site septic system F17� 1 None <br /> 18. Are there any pits,ponds,or lagoons located on the property in connection with waste treatment or waste <br /> disposal.? <br /> Yes Q No El <br /> 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 /> Yes 0 No ® Inoperable agricultural tail-water pond in center of subject properly <br /> b.Any discharges observed within 200 feet? <br /> Yes E:] No <br />