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Oregon Department of Environmental Quality <br /> _• <br /> rp <br /> ® Locate all drain lines in soil absorption system [ es ❑No . <br /> Total length of drain lines (ft) <br /> Lengths determined by[}Physically 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 /> rP PPP <br /> plants etc. <br /> [r'es ❑No <br /> If you answered"No,"please describe below: • <br /> ® Absorption area appears to be free from surface water runoff and down spouts [ es ❑No <br /> Evidence of ponding in absorption area or distribution unit(s) ❑Yes 2ticrci <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 /> v‘z-, r-a <br /> {.F <br /> • Additional Comments: <br /> 6. Sand Filter System - <br /> -There are different sand falter 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 /> Type of sand filter • <br /> O Intermittent <br /> ❑ Recirculating <br /> ❑. Bottomless <br /> Sand filter container appears free from defects,leaks and signs of deterioration: ❑Yes ❑No <br /> Page5of8 <br /> 7 <br />