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8672719
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Last modified
6/28/2019 8:24:13 AM
Creation date
6/18/2019 2:20:29 PM
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Permits
Permit Address
7070 LIBERTY RD S
Permit City
SALEM
Permit Number
555-19-004012-AUTH
Parcel Number
083W28A 00800
Permit Type
Authorization
Permit Doc Type
Permit Document
Status
Ready to Film
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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 /> jYes INo <br /> If youanswered"No,'please describe below: <br /> * Sand filter appears tobe free from surface water runoff and down spouts 1 Yes I No <br /> * Evidence of pondinginjon sand filter media surface r YesL No <br /> * Surface access to manifold and valves _Yes ;^ _iNo <br /> * Monitoring ports are present j Yes No <br /> * Lateral lines flushed andequal distribution verified Li Yes FIN° <br /> * The sand filter has a pump Yes: Luj No <br /> (If"Nor,"skip the rest of section 6) <br /> * Pump vault appears to be watertight`and in good condition i�I Yes No <br /> l �__� J N/A. <br /> * Pump is functional { !Yes I=No <br /> * Pump controlmechanism is functional(floats,pressure transducer) 11___1 Yes J No <br /> * High water alarm in pump vault(audible and visual)is working. i Yes `— <br /> 'No <br /> * Pump electrical`components are sealed.and watertight i_ `.Yes` No <br /> *" Additional Comments: <br /> 7. Alternative Treatment Technology System <br /> The owner of an ATT'system must maintainan annual service contract with a certified'. <br /> Maintenance Provider,.Maintenance records should be available front 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) ,Yes. x No <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 number <br /> Manufacturer name <br /> Page 6 of 8 <br />
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