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12380184
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Last modified
10/1/2024 8:38:05 AM
Creation date
9/19/2024 4:49:59 PM
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Permits
Permit Address
25295 SANTIAM PARK RD SE
Permit City
Lyons
Permit Number
555-21-000222-PRMT
Parcel Number
092E22C 00800
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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• <br /> • Oregon Department of Environmental Quality <br /> • Sand filter unit appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> • plants etc. <br /> DYes❑No <br /> If you answered`No,"please describe below: <br /> • Sand filter appears to be free from surface water runoff and down spouts ['Yes ❑No <br /> • Evidence of ponding in/on sand filter media surface DYes ❑No <br /> • Surface access to manifold and valves DYes ❑No <br /> • Monitoring ports are present ❑Yes ❑No <br /> • Lateral lines flushed and equal distribution verified DYes :No <br /> • The sand filter has a pump DYes ❑No <br /> (If"No",skip the rest of section 6) <br /> • Pump vault appears to be watertight and in good condition DYes ❑No ❑N/A <br /> • Pump is functional DYes ❑No <br /> • Pump control mechanism is functional(floats,pressure transducer)DYes ❑No <br /> • High water alarm in pump vault(audible and visual)is working ['Yes ONo <br /> - • Pump electrical components are sealed and watertight DYes ❑No <br /> a Additional Comments: <br /> 7. Alternative Treatment Technology System <br /> The owner of an ATT system must maintain an annual service contract with a certified <br /> Maintenance Provider.Maintenance records should be avai table from the system owner,or the <br /> contracted Maintenance Provider.Please attach copies of the previous two-years-of <br /> maintenance records to this evaluation form. <br /> Note*Some ATT systems may have a WPCF permit.Please contact the local Health Department <br /> or the DEQ to obtain a copy of the WPCF permit. <br /> • The septic system has an Alternative Treatment Technology(ATT)❑Yes {pvo <br /> (If"No,"skip the rest of section 7) <br /> • Please provide the product name,system ID number,and manufacturer name below: <br /> Product name <br /> System ID number <br /> Manufacturer name <br /> • Page 6 of 8 <br /> • <br /> • <br /> • <br />
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