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• Oregon Department of Environmental Quality <br /> • Locate all drain lines in soil absorption system ['Yes No <br /> Total length of drain lines "l 5o (ft) <br /> Lengths determined by['Physically uncovering portions of system/probing Written records <br /> f iFish tape❑Electronic locator❑camera <br /> • Absorption area appears to be free from roads,vehicular traffic,structures,livestock, deep-rooted <br /> plants etc. <br /> IlYes ❑No <br /> I you answered"No,"please describe below: <br /> -0 Absorption area appears to be free from stuface water runoff and down spouts 1X Yes ❑No <br /> e Evidence of ponding in absorption area or distribution unit(s) ['Yes'No <br /> a The soil absorption system replacement area assigned in the permit record appears to be intact: <br /> [-Wes ENo tsQ.Replacement area not identified in permit record <br /> If you answered"No,"please explain below: <br /> • Additional Com nts: <br /> "jam 1 4 f- _CIi iVidler 1 I I c ` cLort/4 each lei_ <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 records should 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 has a sand filter['Yes ❑No <br /> (If"No."skip the rest of section 6) <br /> O Type of sand filter <br /> ❑ Intermittent <br /> ❑ Recirculating <br /> ❑ Bottomless <br /> a Sand filter container appears free from defects, leaks and signs of deterioration: ❑Yes ['No <br /> Page 6 of 8 <br />