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Oregon Department or`Environmental Quality <br /> • Locate all drain,loses in soil absorption system L3Yes ❑No <br /> Total lenath of drain lines Z° (ft) <br /> Lengths determined by❑Physicall uncovering portions.of:system/probing'[Written records <br /> Fish cape[ `lectronic locator`Vcamera <br /> • Absorption area appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants etc. <br /> ❑Yes moo. <br /> If you answered"No,':please d scribe below: <br /> - orima- <br /> .cl01 a, <br /> Grvikd ,+ W 13044_ <br /> Absorption area appears to be free from surface water runoff and downspouts '❑No <br /> e Evidence of ponding in absorption area or distribution units) ❑Yes ❑No <br /> • The soil absorption system replacement area assigned in the permit record appears to be intact: <br /> ❑Yes ❑Replacement,area:not identified in permit record <br /> If you answered"NO,"please explain below: <br /> ws•dr 1QJ-, s ltt <br /> G Additional Comments: <br /> 6. Sand Fitter-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 sand filter system <br /> permmitted.on or after January 2,2014 must maintain an annual service contract with a certified <br /> Maintenance Provider.Maintenance records should he available from thesystern 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 DYes ❑No <br /> (if"No,"skip the rest of section 6) <br /> • Type of sand filter <br /> 0 Intermittent <br /> ❑ Recirculating <br /> [] Bottomless <br /> e Sand filter container appears free from defects, leaks and signs of deterioration: [(Yes ❑No. <br /> Page 5 of 8 <br />