Septic and Water Assistance Form (Formulario de asistencia séptica y de agua)

This form is for survivors of the Echo Mountain fire who used septic, well, and/or spring fed systems at their affected property. By filling out this form, you agree to let Lincoln County share information with contracted companies to complete inspections, repairs, and potential replacements. If you have any questions or concerns please contact Chrissy Lucas at Chrissy.Lucas@oregonstate.edu or 541-220-0282. (Este formulario es para los sobrevivientes del incendio de Echo Mountain que usaron sistemas sépticos, de pozo y/o alimentados por manantiales en su propiedad que fue afectada. Al llenar este formulario, acepta permitir que el Condado Lincoln comparta información con empresas contratadas para completar inspecciones, reparaciones y posibles reemplazos. Si tiene alguna pregunta o inquietud, comuníquese con Chrissy Lucas en Chrissy.Lucas@oregonstate.edu o 541-220-0282.)

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Please note that in order to qualify you must have been the owner of this property at the time of the Echo Mountain Fire. You must also be the current owner and the property may not be listed for sale.

Has the affected property been cleaned? (¿Se ha limpiado la propiedad afectada?)*
Was the affected property insured? (¿Estaba asegurada la propiedad afectada?*

Select all that apply (Seleccione todas las que correspondan)

Select or enter value (Seleccionar o agregar valor)

Select or enter value
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Select or enter value (Seleccionar o agregar valor)

Select or enter value
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If you have already started services for your well or septic systems, what company are you using? ( Si ya ha empezo los servicios para su pozo o sistemas sépticos, ¿qué empresa está utilizando?)

Thank you (Gracias)

This form is for survivors with septic. well, or spring fed systems on their property. If you need support in other matters, please reach out to Norma Gene at the Salmon River Grange Monday through Saturday 12-3pm. (Este formulario es para sobrevivientes con séptica. pozo, o sistemas alimentados por manantiales en su propiedad. Si necesita apoyo en otros asuntos, comuníquese con Norma Gene en Salmon River Grange de lunes a sábado de 12 a 3 pm.)

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