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Oregon Department of Environmental Quality <br /> a Sand filter unit appears to be free.from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants etc. <br /> DYes ONo <br /> if you answered"No,"please describe below: <br /> © Sand filter.appears to be free from surface water runoff and down spouts DYes ONo <br /> Evidence of pending in/on sand filter media surface Dyes Quo <br /> a Surface access to manifold and valves DYes .ONo <br /> • Monitoring;ports are present Dyes ONo <br /> e Lateral lines flushed and equal,distribution verified Yes ONo <br /> a The sand filter has a pump Dyes ONo <br /> '(If"No",skip the rest of section 6) <br /> a Pump vault appears to be watertight and in good condition DYes ONo .ON/A <br /> a Pump is functional Dyes 'Owe <br /> e Pump control mechanism.is functional(floats,pressure transducer)DYes 0No. <br /> a High Water alarm in pump vault(audible and visual)is working DYes DNa <br /> s Pump electrical components are sealed and watertight DYes 0No <br /> a Additional Corrunents. <br /> 7_ Alternative Treatment Technology System <br /> The owner of an ATT.system-must maintain an annual service contract with a certified <br /> Maintenance Provider Maintenance records shouldbe available from the system owner,or the <br /> contacted 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 a WPCF permit:Please contact the local Health Department <br /> or the DEQ to obtain a copy of the WPCF permit. <br /> a The septic system has an Alternative Treatment Technology ATT)DYes ONe <br /> (if"No,"skip the rest of section 7) <br /> a Please provide the product name,.system ID number,and manufacturer name:below: <br /> Product name <br /> System_ID_number <br /> Manufacturer name <br /> Page of8. <br />