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Oregon Department of Environmental Quality • Locate all drain lines in soil absorption system ®Yes ['No Total length of drain lines (ft) Lengths determined by['Physically uncovering portions of system/probing['Written records ❑Fish tape['Electronic locator ✓❑ camera • Absorption area appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted plants etc. [Yes ❑✓No If you answered"No,"please describe below: Line is under part of the driveway. • Absorption area appears to be free from surface water runoff and down spouts ['Yes No • Evidence of ponding in absorption area or distribution unit(s) ['Yes No • The soil absorption system replacement area assigned in the permit record appears to be intact: ['Yes ❑No©Replacement area not identified in permit record If you answered"No,"please explain below: • Additional Comments: Performed a flow test on the system while observing the water levels at all times.The system accepted all the water provided during the test.The drainfield passes at time of inspection. 6. Sand Filter System There are different sand filter system designs used in Oregon.Not every sand filter system will contain all of the components mentioned below,e.g.pumps. The owner of a sand filter system permitted on or after January 2,2014 must maintain an annual service contract with a certified Maintenance Provider.Maintenance records should be available from the system owner,or the contracted Maintenance Provider.Please attach copies of the previous two years of maintenance records to this evaluation form. • The septic system has a sand filter['Yes No (If"No,"skip the rest of section 6) • Type of sand filter ❑ Intermittent ❑ Recirculating ❑ Bottomless • Sand filter container appears free from defects,leaks and signs of deterioration: ❑Yes No Page 5 of 8