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Oregon Departrnent of Environmental Quality <br /> .1 Sand filter:unit appearsto be free from roads,vehicular traffic;structures,livestock,deep-rooted <br /> plants etc: <br /> ['Yea ONo <br /> If you answered"No,"please describe below: : . <br /> 41 Sand filter appears>to be free:frons surface;water runoff and down spouts ❑Yes ONo <br /> • Evidence of ponding in!on sand filter media surface ❑Yes OND <br /> • Surface access'to manifold and valves:: [YesONo <br /> Monitoring ports are present ❑'Yes !!ONo <br /> •: Lateral lines flushed and equal distribution verified:: ❑Yes ONo <br /> • The sand filter has a pump ❑Yes ONo! <br /> (If"No",skip the rest of section 6) <br /> •. Pump vault appears to be watertight and in good condition ❑Yes ONo ON/A! <br /> 11 11 11 11 I • Pump is functional DYes ONO <br /> • Pump control mechanism is functional(floats,pressure transducer)❑Yes ONo <br /> •; High water alarm in pump vault(audible and visual)is working ❑Yes ONO <br /> • Pump electrical components are sealed and watertight :Yes ONo <br /> • Additional Comments: . <br /> 7. Alternative Treatment Technology System <br /> The owner of an ATT system must maintain an annual se•rvice: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 <br /> maintenance records to this evaluation form; <br /> Note* Some ATT systems may have aWPCF permit.Please Contact the local Health Department <br /> orthe DEQ to;obtain a copy of the WPCF permit. <br /> • The septic system has an Alternative:Treatment Technology(ATT)Oyes NaS <br /> (If"No,"skip the rest of section 7) <br /> • Please provide the product name,system ID number,and manufacturer name below: <br /> Product name: <br /> System ID number <br /> Manufacturername : .. . <br /> Page6of8 <br />