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A <br /> til <br /> Oregon Department of Environmental Quality • <br /> • Locate all drain lines in soil absorption system YesKT; �/7.51- /5 £O4 1 <br /> Total length of drain lines (ft) 9/-&clod- 4-o A4 e e% 11a �'e ®�67 ,G`, <br /> Lengths determin by['Physically uncovering portions of system/probing['Written records <br /> ❑Fish tape Electronic locator❑camera 1..0 G t t"S .41,5d- r (e, ' - d ci C 'F t2 <br /> eicGl_ vi-a 4 cte etc, ��f <br /> .` !o �eL5 •fit e,,--1. c-P Jej <br /> • Absorption area appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted t,e,L/d r1 v t_ <br /> plan c. lecal <br /> es ❑No ' �- <br /> F-;r_rt Icy evciS <br /> If you answered"No,"please describe below: 615 pec , S k,,-,f <br /> • Absorption appears to be free from surface water runoff and down spouts es No <br /> rP area PP ['No <br /> , • Evidence of ponding in absorption area or distribution unit(s) ['Yes <br /> • The s •' absorption system replacement area assigned in the permit record appears to be intact: <br /> es ❑No El Replacement area not identified in permit record <br /> If you answered"No,"please explain below: <br /> • Additional Comments: <br /> ft adt iit,ta4.0 r -car IA A r 4 C ee c e -p 10 ii �u rri dr( , <br /> a y '.4; ( .. 2 o' o ..c.;451- /t q is C;i1 use'-: ,iq fl a-fe-- <br /> ®6Satbes ; Ain) giroVo'el w1+11:ri 30 rl1S.R-.50 ' 1.;d,e tonics <br /> 1J' r-/Aah- o Oto Alk. net,e5/- h d e-P-Piae/ 4 1'l ,+ <br /> 6. Sand Filter System <br /> There are different sand filter 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 .vailable from the system owner,or the <br /> contracted Maintenance Provider:Please attach c I . es of the previous two years of <br /> maintenance records to this evaluation form _ <br /> • The septic system has a sand filter['Yes / ',10 <br /> (If"No,"skip the rest of section 6) <br /> • Type of sand filter <br /> ❑ Inte o i ttent <br /> ❑` Recir, 0 la',:g <br /> ❑ Bottli II ..a <br /> • Sand filter container appears free from defects,leaks and signs of deterioration: ['Yes ❑No <br /> Page 5 of 8 <br />