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Oregon Department of Environmental Quality <br /> Locate all drain lines in soil absorption system Efes ONO <br /> - — <br /> Total length of drain Iiiics_Reis (ft) <br /> Lengths determined by OPhysically uncovering-portions ofsystem/probing nWritten records <br /> OFish tape MEleetonic locarorD camera <br /> e• Absorption area appears to bailee from roads,vehicular traffic,stnicthres,livestock,deep-rnOted <br /> plants etc. <br /> ales EjNo <br /> If you answered“No,"please describe below: <br /> a Absorption, area appears robe free from surface water runoff and down spouts XIYes Ofkle <br /> e Evidence,of ponding in absorption area or distribution unit(s) •DYes 7jNo <br /> • The soil absorption system replacementarea assigned in the permit record appears to be intact <br /> Dyes oN0 Replacement areanot identified in pemit record <br /> If you answered'No"please explain below: <br /> A4ditiOnni Comments; <br /> roper y hO6 5p4le •V-or •repd;r <br /> 6_ Sand Filter System <br /> There are drnerent sand filter system designs used in Oregon.Not every sand filter system will <br /> contain all of the components mentioned below, pumps.The owner of a sand l'ilter system <br /> permitted on or after January 2,2014 must mainrain anannual 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 previbus two years of <br /> maintenance records to this-evaluation fornt. <br /> a The septic system has a sand filter Dyes ONO <br /> (lf''Nb,"skip the rest of section 6) <br /> a Type of sand filter <br /> fl Intermittent <br /> Recirculating <br /> 1:1 Bottomless <br /> a Sand filter container appears free from defects,leaks and sigos of deterioration: Dyes flNo <br /> Page 5 of <br />