Laserfiche WebLink
Oregon Department of Environmental Quality <br /> • Sand filter unit appears to be free from roads,vehicular traffic,structures,livestock,deep-rooted <br /> plants,.,fetc. <br /> !/,IYes❑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 id on sand filter media surface ❑Yes rfiNo <br /> • Surface access to manifold and valves ❑Yes ❑No Ste nr*c baa ou,J <br /> • Monitoring ports are present %Yes ❑No <br /> • Lateral lines flushed and equalalrrrdistribution verified 0Yes ❑No <br /> • The sand filter has a pump mYes ❑No <br /> Of`No",skip the rest of section 6) <br /> • Pump vault appears to,((be watertight and in good condition [$'es ❑No ON/A <br /> • Pump is functional J(es ❑No <br /> • Pump control mechanism is functional(floats,pressure transducer)&Yes ❑No <br /> • High water alarm in pump vault(audible and visual)is working--,! o'es ❑Na <br /> • Pump electrical components are sealed and watertight [a''es ❑No <br /> • Additional Comments: , 1 <br /> "(k Lfl crSxt t'r ..crspc}..� GEV QXS e, acCe&S`) <br /> • • . _ a a_ .t Mit r>(t <br /> AttVf Ctnt121Q5£• <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 available from the system owner,or the <br /> contracted Maintenance Provider.Please attach copies of the previous two years of <br /> maiatetance 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)DYes 0No <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 />