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11855972
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Last modified
9/28/2023 1:37:09 PM
Creation date
9/19/2023 1:56:05 PM
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Permits
Permit Address
11345 EVERGREEN RD NE
Permit City
Silverton
Permit Number
555-23-006807-AUTH
Parcel Number
071W08 00300
Permit Type
Authorization
Permit Doc Type
Permit Document
Status
Ready to Film
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1 <br /> • <br /> '1 Oregon Department of Environmental Quality <br /> Sand filter unit appears to be free from-roads,vehicular traffic,structures,livestocic;deep-rooted <br /> -plants etc.. <br /> 1 DYes*ONO <br /> If you atis-Wered"No,"-pleaSe describe <br /> • <br /> 1Sand filter appears to be free.from surface water rtinoff and down spouts DYes EINo <br /> 1 <br /> 1 • Evidence of ponding in/on sand filter media surface DYes ONo <br /> .3 • Surface access to manifold and valves DYes LINO <br /> • Monitoring ports are present. DYes. EiNo <br /> • Lateral lines-flushed and equal distribution verified Dyes ONo <br /> • The sand filter has a pump DYes 014o <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 /> (1 Pomp is figiotional DYes .0No <br /> • Pump control mechanism is functional(floats,pressure transducer)DYes ONo <br /> 1 <br /> • High:water alarm in pump vault(audible and viSnal)is'Working .DYes <br /> • Puthprelectrical components are sealed and watertight- DYes ENO <br /> • Additional Comments: <br /> 7. Alternative Treatment Technolo&v System <br /> The owner of an ATT system must maintain an annual service contract With a Certified <br /> Maintenance Provider.Maintenance records should be available fi-ornthe 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 /> 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 /> • A The septic system has an Alternative Treatment Technology(ATI)Dyes 12:Vo <br /> (If"No,"-skip the rest of section 7) <br /> • Please provide'the product name,systerdIDnumber,and manufacturer name below:. <br /> Product name. <br /> System ir)number <br /> 1 Manufacturer name <br /> 1 <br /> Page.6 pf.8 <br /> 1. <br />
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