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Septic Site Evaluation 555-24-005772-EVAL Page 2 of 2 DateKrssuedQB/ 112Q Appl eatton stain Stte Oa]uattoi Approoved k � 5 e Wcrkrel scr4ji(ran_°S ,1;1TURE'4MORIt KSFl3 Stakeout required: Yes Yes Groundwater type: Temporary N/A Drainfield type: Standard Standard Drainfield sizing: 150 linear ft/150 gal. 50 linear ft/150 gal. Pump to drainfield required: No Yes Other special requirement: N/A Dosing tank with pump and alarm will be - needed,operation and maintenance agreement will be needed to write permit and must be carried for the life of the system Conditions of approval: •THIS IS NOT YOUR PERMIT.A Construction/Installation permit is required before you construct your system.Please contact this office when you are ready to apply for a construction/installation permit.We cannot sign off on any Building Codes forms until we issue your permit. •This site approval runs with the land and will automatically benefit subsequent owners.This site approval is valid until the approved system is constructed under a DEQ construction permit or unless the site is altered without approval from this office.Alterations/excavations/lot line adjustments made to the site,or placement of wells or utilities,etc.,may invalidate this approval •If you disagree with the decision of this report,you may apply for a site evaluation report review.The application for a site evaluation report review must be submitted to DEQ in writing within 60 days after the site evaluation report issue date and must include the site evaluation review fee in OAR 340-071-0140 Table 9A.A senior DEQ staff person will be assigned the site evaluation report review application. THIS IS NOT YOUR PERMIT.A Construction/Installation permit is required before you construct your system.Please contact this office when you are ready to apply for a construction/installation permit.We cannot sign off on any Building Codes forms until we issue your permit. This site approval runs with the land and will automatically benefit subsequent owners.This site approval is valid until the approved system is constructed under a DEQ construction permit or unless the site is altered without approval from this office. Alterations/excavations/lot line adjustments made to the site,or placement of wells or utilities, etc., may invalidate this approval If you disagree with the decision of this report,you may apply for a site evaluation report review. The application for a site evaluation report review must be submitted to DEQ in writing within 60 days after the site evaluation report issue date and must include the site evaluation review fee in OAR 340-071-0140 Table 9A. A senior DEQ staff person will be assigned the site evaluation report review application. You may apply for a variance to the onsite wastewater treatment system rules. The variance application must include a copy of the site evaluation report, plans and specifications for the proposed system,specify the rule(s)to which a variance is being requested,demonstrate the variance is warranted,and include the variance fee in OAR 340-071-140 Table 9C. A variance may only be granted if the variance officer determines that strict compliance with a rule is inappropriate or special physical conditions render strict compliance unreasonable, burdensome or impractical. A senior DEQ variance officer will be assigned the variance application. OAA4,tke4a. (190A., - Kimberlee Aldrich Onsite Wastewater Specialist 2 /21/2 CALL BEFORE YOU DIG...ITS THE LAW ATTENTION:Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth by Oregon Administration Rules.You may obtain copies of the rules by calling the center.(Note:The telephone number for the Oregon Utility Notification Center is 1-800-332-2344.) 8/21/24:10:30:15AM Page 2 of 2 ONS_OnsiteEvaluation_pr