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10512762
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Last modified
6/29/2021 10:03:13 AM
Creation date
6/25/2021 2:20:26 PM
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Permits
Permit Address
23405 SALMONBERRY WAY SE
Permit City
LYONS
Permit Number
555-21-003530-AUTH
Parcel Number
092E17BD00301
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 /> Permit Records Measured Stamped on Tank 1 Other <br /> * Dosing tank material <br /> * Dosing tank appears to be watertight and in good condition J Yes 1 No <br /> * Dosing tank lid is intact Yes No <br /> * Electrical components are sealed and watertight I Yes No <br /> * Pump/siphon is functional Yes No <br /> * Type of Pump I I Demand dose t Time dose <br /> * Pump control mechanism is functional (floats,pressure transducer) I Yes No <br /> * There is a high water alarm Yes I No <br /> * The high water alarm(audible and visual)is working Yes No 1 Not Applicable <br /> * Type of screen <br /> * Screen is clean and free of debris Yes o <br /> * Screen cleaned for this evaluation 1 1 Yes No <br /> * Scum/sludge present in Dosing tank Yes 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 i x Yes No Unknown <br /> * Was the soil absorption system part of the evaluation? X Yes [ ]No See note below <br /> If the soil absorption system was not evaluated,please explain be ow for example unable to locate,client did not <br /> • authorize this part of the evaluation): <br /> * Absorption distribution X6Equal I Serial Pressure Equal via pressure <br /> * Absorption lines construction material: <br /> X Gravel and pipe Chamber Tile ri Polystyrene foam and pipe I Other <br /> * Absorption distribution unit(s): []dropbox hydrosplitter x equal distribution box <br /> x Intact Damaged N/A - <br /> * Absorption distribution unit(s)are free of debris or solids []Yes No N/A <br /> Page 4 of 8 <br />
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