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r., <br /> f <br /> Oregon Department of Environmental Quality <br /> • Dosing tank capacity (gallons) <br /> • Tank volume determined by:Check all that apply,add comments below as needed <br /> ❑Permit Records❑Measured❑Stamped on Tank❑Other <br /> • • Dosing tank material <br /> • Dosing tank appears to be watertight and in good condition DYes ❑No <br /> • Dosing tank lid is intact DYes ❑No <br /> • Electrical components are sealed and watertight ['Yes ❑No <br /> • Pump/siphon is functional DYes ❑No <br /> • Type of Pump ['Demand dose ❑Time dose <br /> • Pump•control mechanism is functional(floats,pressure transducer)DYes ❑No <br /> • Thereis a,high water alarm DYes [No <br /> • <br /> • The high water alarm(audible and visual)is working ['Yes Olio ['Not Applicable <br /> • Type'of screen <br /> • Screen is clean and free of debris DYes ['No-Screen cleaned for this evaluation Dyes ❑No <br /> • Scum/sludge present in Dosing tank DYes ❑No <br /> • Scum layer (inches) Sludge layer (inches) <br /> • Additional Comments: <br /> 5. Soil absorption system <br /> The soil absorption system is a set of trenches that receives effluent from the septic tank and <br /> filters the effluent before it enters the groundwater. • <br /> • The septic system has a soil absorption system Fires ❑No ['Unknown <br /> • Was the soil absorption system part of the evaluation?SaYes ❑No ❑See note below <br /> if the soil absorption system was not evaluated,please explain below(for example unable to <br /> locate,client did not authorize this part of the evaluation): <br /> • Absorption distribution ''Equal ❑Serial ❑Pressure DEqual via pressure <br /> • Absorption lines construction material: <br /> ' 'VA'Gravel and pipe 0 Chamber Tile ❑Polystyrene foam and pipe ®Other Lahay <br /> • Absorption distribution unit(s): ❑dropbox❑hydrosplittertgequal distribution box <br /> .Intact ❑Damaged 0 N/A <br /> • Absorption distribution unit(s)are free of debris or solids Wes ❑No❑N/A <br /> Page 4 of 8 <br />