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Oregon Department&Environmental Quality <br /> • Sand filter unit appears to he free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants <br /> DYes DNo <br /> If you.answered"No,"please describe below: <br /> • Sand filter appears to be free from surface water runoff and down spouts DYes EjNo <br /> • Evidence of ponding in/on sand filtermediusurface DYes DNo <br /> • Surface access to manifold and valves DYes. ONo <br /> • Moriitoring ports are present DYes ['No <br /> • Lateral lines flushed and equal distribution verified ales DNo <br /> • The sand filter has a pump DYes. DNo <br /> (If"No";skip the rest of section 6) <br /> • Pump vault appears to be watertight and in good condition DYes• ONO ON/A. <br /> • Pump is functional DYes []No <br /> • Pump control mechanism is functional(floats,pressure transducer)DYes ON° <br /> • High water alarm in pump vault(audible and visual)is working DYes [No <br /> • Pump electrical components are sealed and watertight DYes ON° <br /> • Additional.Comments: <br /> 7. Alternative Treatment Technology System <br /> The owner Of an AU system must maintain an annual service contract with a certified, <br /> Maintenance Provider Maintenance records should be available from the system owner,or the <br /> contractedntrecordsto Maintenance Provider.Please attach copies of the previous two years of <br /> enance <br /> . <br /> thistt <br /> I f <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 /> • The septic system has an Alternative Treatment Technology(ATT)['Yes EINo <br /> (If"No,"skip the-rest of section 7) <br /> • Please provide the product name,-system In number,and manufacturer name below: <br /> Product name <br /> System ID number <br /> Manufacturet.name <br /> Page 6 of 8 <br />