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10512295
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10512295
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Last modified
6/25/2021 8:00:13 PM
Creation date
6/25/2021 11:25:52 AM
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Permits
Permit Address
624 CENTRAL AVE W
Permit City
GATES
Permit Number
555-20-008409-AUTH
Parcel Number
093E27DC00300
Permit Type
Authorization
Permit Doc Type
Permit Document
Status
Ready to Film
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Oregon Department of Environmental Quality <br /> • Locate all drain lines in soil absorption system ['Yes ❑No <br /> Total length of drain lines (ft) <br /> Lengths determined by:Physically uncovering portions of system/probing['Written:records <br /> ❑Fish tape[(Electronic locator 0 camera. <br /> • Absorption area appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants etc. <br /> DYes ❑No. <br /> If you answered"No,"please describe below: <br /> • Absorption area appears to be free from surface water runoff and down spouts ❑Yes ❑No <br /> • Evidence of ponding in absorption area or distribution unit(s) ❑Yes ❑No <br /> • The soil absorption system replacement area assigned in the permit record appears to be intact: <br /> ❑Yes ❑No 0:Replacement area not identified in permit record <br /> If you answered"No,"please explain below: <br /> • Additional Comments: <br /> 6. Sand.Filter System. <br /> There are differentsand 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 available fromthe system owner,or the <br /> contracted Maintenance Provider.PIease attach copies of the previous two years of <br /> maintenance records to this evaluation form. <br /> • The septic systemhas a sand fitter['Yes giNo <br /> (If"No,"skip the;rest of section 6) <br /> • Type of sand filter <br /> ❑ Intermittent. <br /> ❑ Recirculating <br /> ❑ Bottomless <br /> • Sand filter container appears free from defects,leaks and signs of deterioration: ❑Yes ❑No <br /> Page 5 of 8 <br />
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