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Oregon Department of EnvironttLontal Quality <br /> •Neuf Ta4K- <br /> The septic tank material is: <br /> Concrete <br /> • r Steel <br /> [2. Plastic <br /> fl Fiberglass <br /> n Other(explain). <br /> E Unknown <br /> fs the septic tank accessible? )7,..1 Yes ONG <br /> a Septic tank volume in gallons ifoo <br /> Tank volume determined by:Check all that apply,add comments below as needed <br /> ti1 Permit Records D Measured P Stamped on Tank 0 Other <br /> * Septic tank risers are at gt-nund level iP2,!Yes UN° <br /> * Tank appears to be free from defects,leaking and signs of deterioration glYes ONO: <br /> If you answered"No"please describe the condition of the septic tank below, For example, <br /> evidence of gas corrosion,cracks,leaks,etc. <br /> 4.0. Septic,tank lid(s)is intact •NYes DWo <br /> • Septic tank baffles are intact Inlet NYes ONG Outlet Des []Nio <br /> Baffle material-inlet EPlastic OConcrete EMetal Outletr Plastic Concrete Metal <br /> Effluent filter is present DYes %IN° <br /> a Effluent filter is free of debris DYes ONopet Applicable <br /> • Liquid level in tank relative to invert of outlet •5KlAt 0Above Ejaelow <br /> If above-or below invert outlet,please expiain: <br /> • scum layer (incheS) Sludge layer (inches) <br /> Scum and Sludge layer more than 35%of the iota/tank volume ales rANo <br /> Indicate where sludge measured from:01-nlet PMiddle FlOttlet <br /> •. Addi lonal Comments: <br /> tadg sce, Rai Si <br /> Dosing.tank/Pump Basin <br /> Dosing tanks use a pump to send effluent to a,treatment unit or a soil absorption field_ <br /> e The septic system tias a dosing tank :lyes ON° <br /> (If"No,"skip tie rest of section 4) <br /> At the time'of this evaluation the;power was on to test the pump(s):Cries EINo <br /> 'Page 3 of 8 <br />