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Oregon Department of Environmental Quality. <br /> * Dosing.tank capacity (gallons) <br /> * Tank_volume determined,by:Check all that apply,add comments below as needed. <br /> 1-11 Permit Records ; Measured _;Stamped on Tank i Other <br /> * Dosing tank.material <br /> * Dosing tank appears to be watertight and in good condition Li Yes 1 No <br /> * Dosing tank lid is intact Yes i—w?No <br /> * Electrical components are sealed and:watertight ��I Yes I -No <br /> * Pump/siphon is functional Yes I ' No <br /> * Type of Pump ! I Demand dose L Time dose <br /> * Pump control mechanism is functional(floats,pressure transducer)' ' i <br /> .v_ I Yes No <br /> " There is a highwater alarm J. <br /> Yes <br /> No <br /> * The high water alarm(audibleand visual)is working t-- Yes � <br /> No _ N of Applicable. <br /> �WH � <br /> * TYAe of Screen <br /> * Screen is clean and free of debris i <br /> ----Yes t....:_:No <br /> * Screen cleaned for this evaluation Yes. ! I No <br /> * ;Scum/sludge present in Dosing tank I I Yes ` No <br /> t <br /> * Scum layer :(inches) Sludge layer (inches) <br /> * Additional Comments: <br /> 5 Soil absorption system <br /> The soil,absorption system is a set of`trenches thatreceives effluent from the septic tankand <br /> filters the effluent before it enters the groundwater. <br /> * The septic system has a soil absorption system C ;x ,Yes j No U_j Unknown <br /> ' * Was the soil absorption system part.of the evaluation? x(:Yes L_J{No L See note below <br /> If the soil absorption system was not evaluated,please explain below(for exampleanable to iocate,:clientdid not <br /> authorizethis'part of evaluation). <br /> * Absorption distribution ',,._:Equal x Serial I 1Pressure ;Equal via pressure <br /> • Absorption lines construction.material: <br /> Gravel and pipe I4 Chamber f Tile ! i Polystyrene foam and pipe. i Other <br /> * Absorption distribution Unit(s): x dropbox ihydrosplitter equal distribution box- <br /> X I Intact ( Damaged i N/A <br /> * Absorption distribution unit(s)are free of debris or solids xEYes _-,INo N/A <br /> Page 4 of 8 <br />