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Oregon Department of Environmental Quality • Locate all drain lines in soil absorption system ®Yes ❑No Total length of drain lines 1000 (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 2No If you answered'No,"please describe below: There is a play area over the too of approximately 60' of 2 of the drain lines. • 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 2No • The soil absorption system replacement area assigned in the permit record appears to be intact: EYes ENo ® Replacement area not identified in permit record If you answered `No."please explain below: There is room for replacement. • Additional Comments: The first distribution box was full of roots, i removed most of them. The second distribution box is full of roots. There are roots in the beaaininas of lines 1-4. Line 4 has roots from the box out 20+'. I was unable to determine if lines 3 and 5 have roots further in the drain lines. Distribution box 1 lid is broken. The effluent water level will have to be determined after roots are all removed. 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 ENo (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