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Oregon Department of Environmental Quality <br /> • Sand filter unit appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants etc. <br /> DYes❑No <br /> IfY ou answered"No,"please lease describe below: <br /> • nd filter appears to be free from surface water runoff and down spoutsYes No <br /> Sand <br /> PP ❑ ❑ <br /> • Evidence of pending in!on sand filter media surface DYes ONe <br /> • Surface access to manifold and valves DYes ❑No <br /> • Monitoring ports are present DYes ❑No <br /> • Lateral lines flushed and equal distribution v ri e ❑ es ❑No <br /> • The sand filter has a pump DYes ❑No <br /> (If"No", skip the rest of section 6) <br /> • Pump vault appears to be watertight and in go d condition DYes ❑No ❑N/A <br /> • Pump is functional DYes ❑No <br /> • Pump control mechanism is functional(floats pressure transducer) DYes ❑No <br /> • High water alarm in pump vault(audible and isual)is working DYes ❑No <br /> • Pump electrical components are sealed and w tertight DYes ❑No <br /> • Additional Comments: <br /> 7. Alternative Treatment Technology System <br /> The owner of an ATT system must maintain an annual service contract with a certified <br /> Maintenance Provider.Maintenance records shouldbe 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 /> Note*Some ATT systems may have a WPCF permit.Please contact the local Health Department <br /> or the DEQ to obtain a copy of the WPCF permit. <br /> • The septic system has an Alternative Treatment Technology(ATT)DYes ZNe <br /> (If"No,"skip the rest of section 7) <br /> • Please provide the product name, system ID number; and manufacturer name below: <br /> Product name <br /> System ID numberIV A- <br /> Manufacturer name <br /> Page 6 of 8 <br />