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I • -... i:: ,:: • ::: :': .: :: ‘: — :: .- - .:. •; :i . :i; : • • .•.:a '' ;F: ..•...' .::: ;i:: :i; ::. •: :i .. :' i: .i :ii . . :. <br /> . ..•• • <br /> . . . <br /> . .. <br /> .. • :4? . .; '" .: :.: ::: :. .: ::. ; ;i ..• ::. •: .• -• , :. <br /> - • <br /> ... . . ... ... .. . Hi : . -. .• . <br /> .•' ... ;;! .•:: Oregon Department of Environmental Quality ], ::: :. ' : • ::: , :. <br /> • - • •, ..- ::: :: .. :: .:i ', . :: •: : ".: e . :: <br /> • •• •• •::. .. ::: :•:e' ::' :ii. i•: :: •• ::. :: :. .. ,: :: :. .: :. ; : :: <br /> • ••. •• :: <br /> • ::: i . :: <br /> • ••.. ,. ( <br /> I . . <br /> :. . <br /> ••. • : <br /> . • . .". • ." ' - ."• . . • . •• • " . .• :. . <br /> .. . ' : .• <br /> Oli The septic fankpi att4ialjs: <br /> • .: <br /> • -.. : <br /> •. .. . •• .. : <br /> -: ::• i :: ri• ']'•:71 Cone±ete:;• :, :: '. :: :. i; ,i .: : <br /> . • • •: ..• <br /> '• *.:: .4 .: , „„: 1:1 Steel.:. <br /> •. • <br /> .: ... • • <br /> i. .::. •:: li :!..- f. D Plastic : :.• -:i : •• .. .. <br /> •• •.. . : <br /> • • <br /> . . : <br /> t 1 ....: !!': i::':: •:: 0 Fiberglass .- <br /> , . <br /> :: :: . .• <br /> : <br /> • " ..! i'..; :: .- --.. 0 Othoir.(explain) '.,! ' :; ::-: ii :: :: ! !: :: • •••• • <br /> •••. : •. <br /> , . <br /> :•• •:: :: - .: •• <br /> • • <br /> El Unknown: :!: ..: ' :•E: i. ' ' :: . :: :. . . <br /> .. :- <br /> .. . .• <br /> • - . <br /> . .. .. . <br /> . .. . : <br /> i Is the:septic tank accessible?';I:.Q Yes EINp ii : : •: :: •• ••.. ..- •• <br /> • - •. . <br /> . : <br /> : : • . <br /> . . - <br /> : . <br /> ; •;. . a Septic tank volume in gallons/ezezy:p:; : *.• !; : : :. ..: ... • . <br /> • .. . : : • <br /> • • • ... . <br /> ii*: Tank volume determined by:Check all that apply,add comments below as needed <br /> . : • <br /> - <br /> - • <br /> Permit.RecOrdS:DUeasUred D Stamped on Tank 0 Other .• • . <br /> • <br /> • <br /> . ;-• - <br /> . . : <br /> • ;:. .,: -.:• 4.. Septic tankrisers are at ground level NYes ON° i• ,:',,, ' . . . <br /> • : : <br /> • <br /> , . • <br /> •• <br /> - .. • : <br /> ••• •.• ,. :.„, •: Tank appears to befiee:fromdefeCts,leaking and signs of detexiorationgYes ION° • • <br /> - <br /> • <br /> ,, .,., :i ;•,:„: . ..„! If you answered"No,"please describe the condition of the septic tank below.For example, ! . <br /> •:.: •••' .: :,* i:: evidence Of gas corrosion,cracks,leaks,etc. ii ::. .: ,:::.:. • .- • • <br /> . :. <br /> .. . <br /> .• -... .. .. . . .. . . ... . . . . . .. .. .. ..... <br /> ••• • ••• • •-• •• •• • • :: :: <br /> . .. . .. . ... . . .. . .. • •.. . <br /> •.: :: . <br /> • —• - "" " - - - <br /> „.: ::: ::: ::: ::: .:: ::: ::: ::: -:: • •:: :: :: :: :: ::.::: . . - • <br /> • • . <br /> -- - <br /> . . •.. . <br /> . . <br /> ... :. . <br /> 4P Septic tank lid(s)is intact Yes Ol4o <br /> . ,• . <br /> .. ... .• <br /> ••• • ••• ••• - • • • - - •• - • - • • • . <br /> . .. . <br /> ii. Septic tank baffles are intact Inlet Wei) Olio Outlet Ili Yes ;D/4o . . <br /> . •.. <br /> . . . <br /> . . <br /> - ••. .. .. <br /> .. :: . <br /> • Baffle material-hilet CIPlaStic riConcrete EMetal Outlet OPlastic [30,Oncrete Metal <br /> :- -• •:. •-- .i_ Effluent filter is present EIYes •KINo :1 : •'. r: ;1 ," ' . .:: :• ::::: • . • <br /> . .. <br /> • <br /> .. ... .. . . .. . •• •• • . <br /> -i '.1., :,:„: :.; • • Effluent filterlis free of debris DYea ONo :',..:1'Not Applicable <br /> : • - <br /> • . <br /> :::• • . . <br /> • <br /> •:: *.:. „: ::, i!, Liquid level in tank relative to invert of outlet T. I.At ElAtkive DB elow • • <br /> - . <br /> • :i::! . . . : <br /> . . <br /> •. . <br /> :-. ;:: -.! •.:: ;:. If above or below invert outlet,please explain ;- -: .:,,- •• <br /> . • . <br /> -,• -. . <br /> :: . • . . <br /> '• :•:: :.i • ::. :: Scum layer .1).Y& (inches)• :'. Sludge layer : ;.i(inches) <br /> .. .. <br /> . : <br /> . : . <br /> • Scum and Sludge layer more than 35%of the total:tank volutne [Wes No •• <br /> . . <br /> . . , . <br /> . . . . <br /> -• •• • ••• •- • ••• ••• -• • • - - . <br /> :,• si. :.; ii' ;:: Indicate where sludge measured froriiii Billet; ['Middle '1!Outlet ' . . • <br /> • • <br /> .. .. ... .. . •. ... . .. .. .. ... . .. •• : . • -•• • • • - .• •• • • • • •-• .: . • - . <br /> ;.• ;;; i:! ;; li: Additional CoMments:;:. : .. : <br /> • • • <br /> - •. . •• • <br /> .. : . <br /> • • : <br /> . . <br /> . : . <br /> : :: .:: :::::. .,:;• .._.: ...„•• .„tank.1, ...:• ...._., .. .E. .; '; i :; i: ; .. • •• •. . <br /> 0. Dosing trump D,asin :; i; :: • I; ;i • :; ;; . <br /> • <br /> ••.. •. : . <br /> . . <br /> .-, <br /> - . <br /> . : <br /> . . <br /> : . <br /> Dosing tanks use apulnp to send effluent to a treatment unit or a soil absorption field. • - • <br /> . . <br /> . . <br /> . . <br /> . : <br /> ! the septic system has a.dosing tank gYes ONE! : !:. : . • • . <br /> . :: .•• . <br /> .: :. . <br /> .• -,!. iii :•,i ,i, ,:: Of"lslo,":skip.the rest of section 4) ; .. :! . :] ; ;; • : .' : : <br /> :. .; ::: :-: • 4 At the time of this'evaluation the power was on to test the pump(s)(s):EYes:DNo <br /> •: •:: •• : • • <br /> ••• - • •••• - •• . ... .. . . . . <br /> - " • •• • "" • - • !• : <br /> •• <br /> : •::: • .. . <br /> . ... .. .. . <br /> :,•: - .. „.; : <br /> . .. ... .. ::. :: :: ... :: : • Page 3 of 8 <br /> •• :::: •• •• - - • - .. .. .. ••• • ,::: . .. <br /> .. . . . <br /> ::• . .. . <br /> . . <br /> .. .. .. ... .. .. .. .. ,. ,, <br /> .. -• .:• : .. . <br /> . . <br /> .. . : <br /> . . . <br /> .: . <br /> • <br /> :: . <br />