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Oregon <br /> - <br /> Oman Department of Environmental Quality <br /> * Locate all drain lines in soil absorption system. pis 0No <br /> Total length of drain lines (fr) <br /> Lengths determined by MI'hysically uncoveringportinns of system/probing "zit=records <br /> 011ish tape 0Electronic locator 0 camera <br /> * Absorption area appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants etc. <br /> Wes ONa <br /> If you answered"lio,"please describe below: <br /> • <br /> * Absorptioui area eppears to be free from surface water runoff and down spouts AYes ONo <br /> • Evidence ofponding in absorption area or di'stribution milks) 0Yes g8:1No, <br /> • The soil absorption system replacemest area assignee in the permit record appeals to be intact <br /> :Wes 0No Cif Replacement area not identified in.permit record <br /> If you answered Please=Plain beim: itti 1 .11. <br /> rten7 41 a Peet -avalkile <br /> • Additional Comments: <br /> • <br /> 6. Sand Filter System <br /> There are different sand filter system designs used in Orego.n: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 /> Utaintenance Provider.Maintenance records should be available from the system owner,or the <br /> contracted Msirrt*nonce ProVider:Please attach copies of the previous two years of <br /> maintenance records to this evaluation form. <br /> • The septic system bas a sand filter[]Yes 1No <br /> of"No,"skip the rest of section 6) <br /> * Type of sand filter <br /> O Intermittent <br /> 0- Recirculating <br /> O Bottomless <br /> • Sand filter container appears free from defects,leaks and signs of deterioration: 0Yes ON° <br /> Page 5 of 8 <br />