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<br /> '..Oregon D6partfnent of Environmental Quality
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<br /> • Locate all drain lines in:soil absorption system::::0Y•es ONO:,
<br /> Total length of thain lines I, (ft)
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<br /> Lengths determined by 1.:1Physicajiy uncovering portions of system/probing 0Written records
<br /> EFish tape 0Eleetroitic locator 0 camera
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<br /> • Absorption area appears to be free fronarOads,Vehieular traffic,structures,livestock,deep-rooted
<br /> planta etc ,
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<br /> DY60 EIN0'1, i,i ,: '',i , i ,• ,•
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<br /> If you answered"No,"please describe below
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<br /> • Absorption area appears to be free from surface water runoff and down spouts 0-Yes 0No
<br /> • Evidence of ponding in absorption area or distribution unit(s) OYes [1N° , il
<br /> • The soil absorption system replacement area assigned in the permit record appears to be intact:
<br /> DY00No 0 Replacement area not identified in permit record • •
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<br /> If you answered"No,"please explain bele*:
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<br /> Additional Comments::: ,, , :,
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<br /> 6 Sand:Bit r System
<br /> !! i There are different sand filter system designs used in Oregon Not every sand filter system will
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<br /> contain all of the components mentioned below,e.g.pumps The owner of a sand filter system
<br /> permitted on or after January 2,2014 must maintain an annual service contract with a certified
<br /> Maintenance Provider:Maintenance records should be available from the system owner,or the
<br /> contracted Maintenance ProVider;!Please attach copies of the previous two years of
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<br /> maintenance records to this evaluation form. -• • : :
<br /> • The septic systemhas a sand filter ElYes,INNo
<br /> (If"No,'skip the rest of section 6)
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<br /> • Type,of sand fdter! •:i.i . ::: : : -
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<br /> 0ilntermittent
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<br /> 0 3otiff:pniless , :„., , , . . .. .
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<br /> • Smut filter container appears free from defects! leaks and signs of deterioration: []Yes 0No
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<br /> : !!, P .ge 5 of 8
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