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Oregon Department of Environmental Quality <br /> * The septic tank material is: <br /> [—xi Concrete <br /> Steel <br /> (. _ Plastic <br /> [_._1 Fiberglass <br /> E Other(explain) <br /> L_ I Unknown <br /> * Is the septic tank accessible? rx Yes CL.µj No <br /> * Septic tank volume in gallons <br /> * Tank volume determined by:Check all that apply,add comments below as needed <br /> Permit Records L Measured I JStamped on Tank [ tOther <br /> * Septic tank risers are at ground level. _ _�Yes x l No <br /> * Tank appears to be free from defects, leaking and signs of deterioration -� Yes E_ _xi No <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 /> 4/2/2024-FILLED TANK WITH WATER,MEASURED LIQUID AT 12.5" 4/4/2024-MEASURED LIQUID LEVEL AT 14.5"-DROPPED 2" <br /> 4/8/2024-MEASURED LIQUID LEVEL BEFORE PUMPING-MEASURED 19"DROPPED 6.5"SINCE 4/2/2024.TANK IS LEAKING. <br /> * Septic tank lid(s)is intact lx_i Yes ( _f No <br /> * Septic tank baffles are intact: Inlet f xJ Yes [ ]No Outlet x ,Yes* ��No <br /> Baffle material-Inlet ' __4 Plastic I -]Concrete I X l Metal <br /> Outlet i Plastic [ f Concrete X l Metal <br /> * Effluent filter is present _I Yes ! x.1 No <br /> * Effluent filter is free of debris No Yes I <br /> z-._.._� � x 1 Not applicable <br /> * Liquid level in tank relative to invert of outlet ID At J Above i xJ Below <br /> If above or below invert outlet,please explain: LIQUID 19" BELOW OPERATING LEVEL <br /> * Scum layer 0 (inches) Sludge layer 24 (inches) <br /> r--- <br /> * Scum and Sludge layer more than 35%of the total tank volume L xi Yes No <br /> Indicate where sludge measured from: L _ Inlet [.__x i Middle L__M Outlet <br /> * Additional comments: <br /> 4. Dosing Tank/Pump Basin <br /> Dosing tanks use a pump to send effluent to a treatment unit or soil absorption field. <br /> • The septic system has a dosing tank Yes (_- x 1 No <br /> (If"No,"skip the rest of section 4) <br /> F--- <br /> * At the time of this evaluation the power was on to test the pump(s): ; Yes Li No <br /> Page 3 of 8 <br />