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Last modified
4/12/2019 8:35:18 AM
Creation date
4/11/2019 9:46:08 AM
Metadata
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Template:
Permits
Permit Address
21965 CAMELLIA CT NE
Permit City
AURORA
Permit Number
555-19-002327-AUTH
Parcel Number
041W11CA01900
Permit Type
Authorization
Permit Doc Type
Permit Document
Status
Ready to Film
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Oregon Department of Environmental Quality <br /> • The septic tank material is: <br /> rIConcrete <br /> Steel <br /> Plastic <br /> 0 Fiberglass <br /> ❑ Other(explain) <br /> E Unknown <br /> • Is the septic tank accessible? I`es ❑No <br /> • Septic tank volume in gallons frOW <br /> • Tank volume determined by: Check all that apply,add comments below as needed <br /> ❑Permit Records r Measured❑ Stamped on Tank❑Other <br /> • Septic tank risers are at ground level ❑Yes t'No Zit av41.45 do.441 <br /> • Tank appears to be free from defects,leaking and signs of deterioration' 'es ❑No <br /> If you answered"No,"please describe the condition of the septic tank below.For example, <br /> evidence of gas corrosion,cracks,leaks, etc. <br /> • Septic tank lid(s)is intact Tges ❑No <br /> • Septic tank baffles are intact:Inlet i''es ['No Outlet ees No <br /> • Baffle material-Inlet I JPlastic ❑Concrete Metal Outlet Plastic ❑Concrete fetal <br /> Effluent filter is present ❑Yes To - <br /> • Effluent filter is free of debris ❑Yes ❑No jot Applicable <br /> • Liquid level in tank relative to invert of outlet Ickt ❑Above ❑Below <br /> If above or below invert outlet,please explain: <br /> • Scum layer (inches) Sludge layer a (inches) <br /> • Scum and Sludge layer more than 35%of the total tank volume ❑Yes ►. �o <br /> Indicate where sludge measured from:❑Inlet dle0utlet <br /> • Additional Comments: <br /> 4. Dosing tank/Pump Basin <br /> Dosing tanks use a pump to send effluent to a treatment unit or a soil absorption field. <br /> • The septic system has a dosing tank ❑Yes ,[To <br /> (If"No,"skip the rest of section 4) <br /> • At the time of this evaluation the power was on to test the pump(s): ❑Yes ❑No <br /> Page 3 of 8 <br />
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