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Oregon Department of Environmental Quality <br /> _604 Piped otspeck, 4404h, COA;#1 <br /> C The septic tank material is: <br /> • Concrete <br /> El Steel <br /> t.::i Plastic <br /> • Fiberglass <br /> l Other(explain) <br /> ri 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 Q Stamped on Tank❑Other <br /> • Septic tank risers are at ground level ['Yes ONo <br /> • 'Tank appears to be free from defects, leaking and signs of deterioration❑Yes [No <br /> if you answered"No,"please describe the condition of the septic tank below.i=oi•example, <br /> evidence of-gas corrosion,cracks,leaks,etc. <br /> • Septic tank lid(s)is intact QYes :UNo <br /> • Septic tank baffles are intact: Inlet DYes ❑No Outlet Dies ['No <br /> €`iConerete• Baffle material-Inlet Plastic (JConcrete �'-`Tvtetal Outlet Plastic 'Metal <br /> Effluent filter is present []Yes []No <br /> • Effluent fitter is free of debris ❑Yes LINe ❑Not Applicable <br /> ® Liquid level in tank relative to invert of outlet DM [Above ElBetow <br /> If above or below invert outlet,please explain: <br /> • Scum layer (inches) Sludge layer (inches) <br /> • Stun and Sludge layer more th an 35%of the total tank volume UYes [}No <br /> indicate. where sludge,measured from:EjTnlet []Middle []Outlet. <br /> • Additional Comments: <br /> 4, Dosing tank/Ppsn.p Basin <br /> Dosing tanks use a.pump to send effluent to a treatment unit or a soil absorption field. <br /> o The septic system has dosingtank [Yes ❑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):[ly es ONo <br /> Page 3 of 8 <br />