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Oregon Department of Environmental Quality <br /> * Locate all drain lines in soil absorption system ! x Yes No <br /> Total length of drain lines that were able to be located 450 (ft) <br /> Lengths determined by x Physically uncovering portions of system/probing X ! Written records <br /> �I x Fish tape i x Electronic locator ; camera <br /> * Absorption area appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants etc. <br /> x I Yes L I;No <br /> If you answered "No," please describe below: <br /> 1-1 <br /> * Absorption area appears to be free from surface water runoff and down spouts _x_:Yes No <br /> * Evidence of ponding in absorption area or distribution unit(s) Yes L x J No <br /> * The soil absorption system replacement area assigned in the permit record appears to be intact: <br /> x Yes {No Replacement area not identified in permit record <br /> If you answered "No," please explain below: <br /> * Additional Comments: <br /> 6. Sand Filter System <br /> There are different sand filter system designs used in Oregon. Not every sand filter system will <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 <br /> maintenance records to this evaluation form. <br /> * The septic system has a sand filter _ Yes . x !No <br /> (If"No,"skip the rest of section 6) <br /> * Type of sand filter <br /> Intermittent <br /> _ I Re-circulating <br /> I Bottomless <br /> * Sand filter container appearssignsNo <br /> free from defects, leaks and of deterioration: Yes <br /> Page 5of8 <br />