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Oregon Department of Environmental Quality <br /> • Locate all drain lines in-soil absorption system ( Yes ONO <br /> Total length of&dm lines 0 (ft) <br /> Lengths determined by DPhysically uncovering portions of system/probing DWritten records <br /> OFiSh tape Ktlectronic locator 0 camera <br /> • Absorption area appears to be free from roads,vehicular traffic;structures,livestock,deep-rooted <br /> plants etc.. <br /> DYes DNo <br /> If you answered"NO,"please describe.below: <br /> • Absorption area appears to be free from surface water runoff and down spouts [ Yes ONo <br /> • Evidence,ofponding in absorption area or distribution unit(a) DYes [it° <br /> fi The soil absorption system replacement area assigned in the permit record appears to be intact: <br /> DYes EINo Ecil Replacement ereA nOtidentified 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 record.sshould 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 hasa sand filter DYes DNo <br /> (If"No,"skip the rest of secficin 6) <br /> • Type of sand filter <br /> [3 Intermittent <br /> El Recirculating <br /> O Bottomless <br /> • Sand filter container appears free from defects,leaks and signs of deterioration: DYes ONo <br /> Page 5 of 8 <br />