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Oregon Department of Environmental Quality <br /> Tank missing after clean up. <br /> • The septic tank material is: <br /> ID Concrete <br /> ED Steel <br /> Plastic <br /> Fiberglass <br /> El Other(explain) <br /> LA Unknown <br /> • Is the septic tank accessible? ❑Yes No <br /> • Septic tank volume in gallons <br /> • Tank volume determined by: Check all that apply, add comments below as needed <br /> ❑Permit Records❑Measured❑ Stamped on Tank❑ Other <br /> • Septic tank risers are at ground level ['Yes ]No <br /> • Tank appears to be free from defects, leaking and signs of deterioration❑Yes IZNo <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 /> Missing <br /> • Septic tank lid(s)is intact ['Yes No <br /> • Septic tank baffles are intact: Inlet ['Yes No Outlet ❑Yes No <br /> • Baffle material-Inlet OPlastic MConcrete OMetal Outlet Mastic ❑Concrete OMetal <br /> Effluent filter is present ['Yes ZNo <br /> • Effluent filter is free of debris ['Yes ❑No I1Not Applicable <br /> • Liquid level in tank relative to invert of outlet ❑At ['Above ❑Below <br /> If above or below invert outlet,please explain: <br /> • Scum layer (inches) Sludge layer (inches) <br /> • Scum and Sludge layer more than 35%of the total tank volume ❑Yes ❑No <br /> Indicate where sludge measured from: ❑Inlet ['Middle [Outlet <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 EYes ❑No <br /> (If"No,"skip the rest of section 4) <br /> • At the time of this evaluation the power was on to test the pump(s): ❑Yes ❑No <br /> Page 3 of 8 <br />