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Oregon Department of Envir'nmental Quality • Dosing tank caps.ity 406 • (gallons) • Tank volume dete fined by:Check all that apply,add comments below as needed .0 Permit Record. D Measured 0 Stamped on Tank D Other • Dosing tank mate ial • Dosing tank app-. s to be watertight and in good condition DYes ONo • Dosing tank lid is ,ntact DYes ONo • Electrical compon-nts are sealed and watertight DYes ONo • Pump/siphon is f nctional DYes ONo • Type of Pump (I Demand dose OTime dose • Pump control mec anism is functional(floats,pressure transducer)DYes ONo • There is a high wa -r alarm DYes DNo • The high water al. (audible and visual)is working • DYes ONo ONot Applicable • Type of screen • Screen is clean an. free of debris Dyes ONo-Screen cleaned for this evaluation DYes DNo • Scum/sludge pres•nt in Dosing tank DYes. .DNo • Scum layer (inches) Sludge layer (inches) • Additional Comm;nts: 5. Soil absorption s tem . The soil absorptio system is a set of trenches that receives effluent from the septic.tank and filters the effluent efore it enters the groundwater. • The septic system as a soil absorption systemWes ONo DUnknown -Was the soil abso1.1 tion system part of the evaluation?rglYes ONo DSee note below If the soil abso ption system was not evaluated,please explain below(for example unable to locate,client d d not authorize this part of the evaluation): • Absorption distrib tion. DEqual Medal OPressure DEqual via pressure • Absorption lines c nstruction material: 1): Gravel and pipe Chamber 0 Tile 0 Polystyrene foam and pipe DOther .._•...Absorption.distrib tion unit(s):Ddropbox Dhydrosplitter['equal distribution box D Intact 0 Damaged p N/A • ._:Absorptioi distrib ion'unit(s)are free'of�debris==or-solids Dyes DNo p N/A Page4of8