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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 Ll(0 (ft) <br /> Lengths determined by IZIPhysically uncovering portions of system/probing Written records <br /> ['Fish tape['Electronic locator❑ camera <br /> • Absorption area appears to be free from roads,vehicular traffic,structures,livestock, deep-rooted <br /> plants etc. <br /> 'g(Yes Po <br /> If yo answered"No,"please describe be ow: _j_ <br /> c,r-s (!.nr c,� Lu= -A"ij i! ,--c' 'foto r Alti{5 .. <br /> .fig <br /> • Absorption area appears to be free from surface water runoff and down spouts ? Yes ❑No <br /> • Evidence of ponding in absorption area or distribution unit(s) [Yes .1No <br /> • The soil absorption system replacement area assigned in the permit record appears to be intact: <br /> ❑Yes ❑No❑Replacement area not identified in permit record <br /> If you answered"No,"please explain below: <br /> • Additional Comments: <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 ;SINo <br /> (If"No,"skip the rest of section 6) <br /> • Type of sand filter <br /> ❑ Intermittent <br /> ❑ Recirculating <br /> ❑ Bottomless <br /> • Sand filter container appears free from defects,leaks and signs of deterioration: ['Yes ❑No <br /> Page 5 of 8 <br />