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1 1 <br /> 1 <br /> . i <br /> Oregon Department of Envinthmental.Quality <br /> t Tott.;IA as fut441',U.S: 1 v&-te' 5 i-.......1 'no _ : . . . . . <br /> 1 <br /> - 1 <br /> 1 • The septic tank material is: <br /> t <br /> , E Concrete <br /> 1 <br /> 0 Steel. <br /> .1 12 Plastic <br /> 1 Fiberglass:. <br /> El Other(explain) <br /> 1 0 Unknown <br /> • I • Is the septic tank accessible?:lgiYes ElNo <br /> 1 • Septic tank volume in gallons 0010 6rA-6-4;X: i),,t9e6v414"404C :ifq42:5' Itk.1.1 <br /> i t9.... cowf.A.-ttr p <br /> la Taikvolurne determined by:Check all thatapply;.add comments below as nee ed <br /> . t <br /> 1 1 Ea pdithitkedords.fiRMOastutd 0 Stamped ciri Tarik 0 Other <br /> i 1 <br /> 4 <br /> ; 1 • :Septic tank risers Are at ground level. RYes 0No <br /> . , <br /> I • Tank appears to be:free from defects,leaking and.signs of deterioration[ Yes 1:1No <br /> 1 lIfyou answered:"No,"please describe the condition ofthe septic.tank below.For example, <br /> i <br /> 1 evidence of gas eorrositin,cracks;leaks,etc. <br /> I <br /> 14tai< okieve, 40 19e i , ."-t64 ,C.444cit .."'.tcs•Ak .41,6 y," .1- ftelei.J... <br /> 17 rtTlAtt.. eroje .7 See_ A44-ealt,c% (jou-045 fere:If-A- <br /> I .0 :Septic tank licks).is intact lYes 0No <br /> ; 1 <br /> I 1 -0 Septic tank baffles are intact:.Inlet.glYes .E1No Outlet dYes •Ell\To <br /> si <br /> 1 I • Baffle material.-Inlet gPlastic 07 Concrete DIN/fetal Outlet ZPIastic El-,COncrete Metal <br /> i 1 <br /> 1 Effluent filter is present Ores ONo <br /> 1 <br /> i • Effluent filter is free.of debtis ( Yes.. Olio :Riot Applicable <br /> • Liquid level in tank relative to invert,of.outlet RIAt, ElAbove 013elOw <br /> iIf above or below invert oudet,please explain: A//A <br /> .- <br /> i - <br /> • 'Scum layer 1 (itches) iShidge layer la" (inches) <br /> • Scum and Sludge layer more than 35%of the total tank volume 0_Yes gNo <br /> i 1 Indicate where sludge MeaStited;from.:Ewa [Middle 7.20atl..4 <br /> . Additional Comments: <br /> 1 <br /> 1 . . <br /> 1 4. Dosing tank tPump-Basin <br /> •i <br /> 1 a Dosing tanks use a pump to send effluent to a treatment unit or asoil absorption field. <br /> II • The septic systerrilis.a:dosing tank Dyes. Eallo <br /> 1 1 -Of-"No;"skip the rest of section 4) <br /> i 1 <br /> 1 i • At the time..of this evaluation the power was on to test the pootp(s): Yes 10No <br /> 1 / <br /> ! 1 <br /> I <br /> 1 1 Page 3 pf 8 <br /> 1 i <br /> i 1 <br /> i 4 . <br /> I <br /> i . <br /> 4 <br />