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., <br /> EXISTING c N ING SYSTEM EVALUATION REPORT x EXISTING SEPTIC I J RE c' E k', <br /> Existing System Evaluation Report for S n itaPR 04 2022'-, <br /> Wastewater Systems . MARION COUNTY.., <br /> DEQ BUILDING INSPECTION <br /> :; ' State of Oregon Department of Environmental Quality . <br /> Onsite Program <br /> 165 East 7th Avenue, Suite 100 <br /> Eugene,Oregon 97401 <br /> Please answer the following questions completely. Do not leave any blank responses.Write unknown it <br /> unknown. Refer to Oregon Administrative Rule 340-071-0155 for more information,and please visit <br /> https://www.oregon.gov/deq/Residential/Pages/Septic-Smart.aspx <br /> Septic System Owner-Provided Information: <br /> Property Owner(s)(Sellers) LARRY LOOMIS-PRICE Telephone <br /> • <br /> Site Address 35404 FRANCIS ST SE City: LYONS Zip Code; 97358 <br /> County: MARION Lot Size: 0.49. Acres/S uare Feet(circle units.);- <br /> . v <br /> j Legal Description: T 8 R 4E SEC 32BD TL 1600 <br /> Age of wastewater treatment system N/A (years) Is there a service contract for system components?:. NO <br /> Date the septic tank was last pumped UNKNOWN (please attach receipt if available) <br /> Number of people occupying the dwelling 0 If unoccupied,how long has it been vacant 6 MONTHS <br /> Was this section completed by the evaluator because own or agent was unavailable? YES • <br /> The above information is true and to the best of my knowledge. <br /> 3/1/2021 SPOKE TO LARRY VIA PHONE <br /> Date(MM/DD/YYYY) Signature of Owner <br /> Name of person performing inspection(please print) CHRIS RHODABACK -`"- <br /> y • Cerfification: <br /> Installer Professional Engineer <br /> X Maintenance Provider 1 Environmental Health Specialist <br /> National Association of Wastewater Technicians Wastewater Specialist <br /> Other DEQ approved in writing(please describe) <br /> Certification Number: RM 8 <br /> ' Business name: A&B Septic Service/Valley Septic Service Email a_b_septic@hotmail.com <br /> Business address:P.O.Box 444,Albany,Or,97321 Phone: 1-866-927-1156 <br /> j Date of Evaluation: 3/18/2021 (MM/DD/YYYY) <br /> T, <br /> I hereby certify,by my signature,that I meet all of the qualifications required to perform onsite wastewater <br /> system evaluations in the state of Oregon pursuant to OAR 340-071-0155. <br /> 03/18/2021 CHRIS RHODABACK <br /> Date(MM/DD/YYYY) Signature of Qualified Septic System Evaluator <br /> Page 1 of 8 Updated 12/29/2016 <br /> . <br />