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.. Oregon Department'of Environmental Quality - - . <br /> • . i <br /> • The septic tankmaterial is: • . . , <br /> 8. Concrete ' <br /> Steel <br /> ® - Plastic . <br /> • El Fiberglass • . - <br /> ® Other{explain) <br /> © Unknown • <br /> • Is the septic tank accessible? VIYes DNo • <br /> • Septic tank volume in gallons LOD. <br /> • Tank volume determined by:Check all that apply,add comments below as needed <br /> 0 Permit Records[]Measured D Stamped on Tank Dglotber • . <br /> • Septic tank risers are at ground level Ayes :No <br /> • • • Tank appears to be free from defects;leaking and signs of deterioration Pes DNo <br /> - • If you answered"No,"please describe the condition of the septic tank below.For example, <br /> evidence of gas corrosion,cracks,leaks,etc. • <br /> • Septic tank lid(s)is intact %Yes ['No <br /> • Septic tank baffles are intact;Inlet Wes DNo Outlet [ Yes DNo . <br /> • Baffle material-Inlet qtlastic Croncrete ElMetal Outlet Plastic OConcrete []Metal <br /> Effluent filter is present DYes %No <br /> • Effluent filter is free of debris ['Yes ['No (Not Applicable <br /> • • Liquid level in tank relative to invert of outlet CkAt ['Above ['Below <br /> If above or below invert outlet,please explain: <br /> • Scum layer • 3 (inches) . Sludge layer b (inches) ' - 1 ' <br /> • Scum'and Sludge layer more than 35%of the total tank volume.DYes IgNo <br /> • Indicate where sludge measured from:['Inlet ['Middle ► •utlet <br /> • Additional Comments: <br /> 4. Dosing tank/Pump Basin - <br /> Dosing tanks use a pump to send effluent to a treatment unit or a soil absorption field. <br /> • The septic system-'has a dosing tank DYes ( io • <br /> (If"No,"skip the rest of section 4) - <br /> • At the time of this evaluation the power was on to test the puip(s): ['Yes DNo <br /> Page3of8 <br /> • <br />