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Oregon Department of Environmental Quality • Locate all drain lines in soil absorption system Yes ❑No e Total length of drain lines I q© (ft) Lengths determined byPhys ci a l uncoverinortions of syste probin ❑Written records ❑Fish tape❑Electronic locator❑'camera • Absorption area appears to be free from roads,vehicular traffic,structures,livestoc eep-rooted plants etc. ❑Yes T�No If you answered"No,"please describe below: ¶rZeS ri, area b-F' drq,'n ,'e f b z4-weefi / e9 S • Absorption area appears to be free from surface water runoff and down spouts [/Yss ❑No • Evidence of ponding in absorption area or distribution unit(s) ['Yes No • The soil absorption system replacement area assigned in the permit record appears to be intact: EYes Mi--"teplacement area not identified in permit record If you answered"No,"please explain below: • Additional Comments: IS 0, cn wri4 er 'or J/z hi- Cvq+er fa3euP ovc+ 1.�' .I-han ara,-i.ed back denw✓l 0,-}11 4-Lf os-P ,e93s ti a v e oc.ta owt- :.► % o-P .s+a �► �� w�f �-, 6. Sand Filter System There are different sand filter system designs used in Oregon.Not every sand filter system will contain all of the components mentioned below, e.g.pumps. The owner of a sand filter system permitted on or after January 2,2014 must maintain an annual service contract with a certified Maintenance Provider.Maintenance records should be available from the system owner,or the contracted Maintenance Provider.Please attach copies of the previous two years of maintenance records to this evaluation for • The septic system has a sand filter❑YesNo (If"No,"skip the rest of section 6) • Type of sand filter ❑ Intermittent ❑ Recirculating A) El Bottomless • Sand filter container appears free from defects,leaks and signs of deterioration: ❑Yes ❑No Jo Page 5 of 8