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Houci_ <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 D Measured❑Stamped on Tank D Other <br /> • Dosing tank material <br /> .. <br /> • Dosing tank appears to be watertight and In good condition DYes DNo <br /> • Dosing tank lid is intact DYes ONo • <br /> • Electrical components are sealed and watertight. Dyes DNo <br /> • Pump/siphon is functional tries []No' <br /> • Type of Pump []Demand dose [Tune dose <br /> *, Pump control mechanism is flmct ianal(floats,pregame transducer)DYes DNo <br /> • There is a iugh water alarm DYes DNo <br /> • The high water alarm(audible and visual)is working DYes DNo DNotApplicablle <br /> • Type of screen <br /> • Screen is clean and free of debris DYes ONo-Screen cleaned for this ovallpation DYes DNo • <br /> • Scum/sludge present in Dosing tank Dyes ONo <br /> • Scum layer (orches) Sludge layer` it les: <br /> •. ,ldditi+on Comments: <br /> 5. Soil absorption system <br /> The soil absorption system is a set of trenches that receives-affluent from the septic tank and <br /> P <br /> Eters the effluent before it enters tie ground <br /> • The septic system has a soil absorption system Wes ONo ❑Unknown <br /> a Was the soil absorption systempart of the evaluation?Wes ❑No OSee 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 via pressure <br /> essae <br /> • Absorption lines construction material <br /> Gravel and pipe.0 Chamber D The ❑Polystyrene foam and pipe DOtber <br /> • Absorption distribution unit(s):Ddropbox❑hydros flitter glequal distribution box <br /> {x Intact ❑Damaged D N/A <br /> , Absorption distribution units)are free of debris or solids jlf Yes ONo❑N/A <br /> Page 4 of S <br />