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Oregon Department of Environmental Quality * Locate all drain lines in soil absorption system x Yes No Total length of drain lines that were able to be located 123 (ft) Lengths determined by x Physically uncovering portions of system/probing Written records Fish tape x Electronic locator camera * Absorption area appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted plants etc. Yes x No If you answered "No," please describe below: THERE IS EVIDENCE OF ROOTS IN THE SOIL ABSORPTION AREA. * Absorption area appears to be free from surface water runoff and down spouts x Yes No * Evidence of ponding in absorption area or distribution unit(s) Yes x No * The soil absorption system replacement area assigned in the permit record appears to be intact: Yes No x Replacement area not identified in permit record If you answered "No," please explain below: * Additional Comments: IN THE DRAINFIELD,RAN LOCATOR DOWN LINE 1 AND FOUND ROOTS AND ROCKS IN THE LINE.THE LINE IS ALSO CRUSHED. THE OTHER 2 LINES ARE SHORT.RECOMMEND FURTHER INVESTIGATION OF THE DRAINFIELD. 6. Sand Filter System There are different sand filter system designs used in Oregon. Not every sand filter system will contain all of the components mentioned below,e.g.pumps. The owner of a sand filter system permitted on or after January 2,2014 must maintain an annual service contract with a certified Maintenance Provider. Maintenance records should be available from the system owner,or the contracted Maintenance Provider.Please attach copies of the previous two years of maintenance records to this evaluation form. * The septic system has a sand filter Yes x No (If"No,"skip the rest of section 6) * Type of sand filter Intermittent Re-circulating Bottomless * Sand filter container appears free from defects,leaks and signs of deterioration: Yes No Page 5 of 8