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10512288
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Last modified
6/25/2021 8:00:13 PM
Creation date
6/25/2021 11:25:44 AM
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Permits
Permit Address
25852 DEWITT LN SE
Permit City
LYONS
Permit Number
555-20-008461-AUTH
Parcel Number
092E22D 01500
Permit Type
Authorization
Permit Doc Type
Permit Document
Status
Ready to Film
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Oregon Department of Environmental Quality <br /> • Dosing tank capacity (gallons) <br /> • Tank volume determined by: Check all that apply, add comments below as needed <br /> E.Permit Records E Measured❑ Stamped on Tank E Other <br /> • Dosing tank material <br /> • Dosing tank appears to be watertight and in good condition ['Yes ['No <br /> • Dosing tank lid is intact Oyes ❑No <br /> • Electrical components are sealed and watertight Eyes [No <br /> • Pump/siphon is functional Dyes [No <br /> • Type of Pump ['Demand dose ❑Time dose <br /> • Pump control mechanism is functional(floats,pressure transducer) Eyes ❑No <br /> • There is a high water alarm Dyes ❑No <br /> • The high water alarm(audible and visual)is working Eyes ❑No ['Not Applicable <br /> • Type of screen <br /> • Screen is clean and free of debris Dyes ['No-Screen cleaned for this evaluation Eyes [No <br /> • Scum/sludge present in Dosing tank Eyes [No <br /> • Scum layer (inches) Sludge layer (inches) <br /> • Additional Comments: <br /> 5. Soil absorption system <br /> The soil absorption system is a set of trenches that receives effluent from the septic tank and <br /> filters the effluent before it enters the groundwater. <br /> • The septic system has a soil absorption system MYes ❑No ❑Unknown <br /> • Was the soil absorption system part of the evaluation?pes ❑No ❑See note below <br /> If the soil absorption system was not evaluated,please explain below(for example unable to <br /> locate, client did not authorize this part of the evaluation): <br /> • Absorption distribution XEqual ['Serial ['Pressure ['Equal via pressure <br /> • Absorption lines construction material: <br /> IgLoravel and pipe E Chamber E Tile ❑Polystyrene foam and pipe ['Other <br /> • Absorption distribution unit(s): ❑dropbox❑hydrosplitter%equal distribution box <br /> r►< Intact E Damaged E N/A <br /> • Absorption distribution unit(s) are free of debris or solids 1)7 Yes ❑No❑N/A <br /> Page 4 of 8 <br />
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