HomeMy WebLinkAbout2013 Easton Drive - SL - 2022.09.30 (25)City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address: Tested Date:
Owner: � Building Permit #:
Contractor Name: (>,, ��\, 1 Encroachment Permit #:
City Staff Name: PC —Z \
Cleanout Location: Front ❑ Rear eft ❑ Right
Face of Curb
Lateral Size: �,
Cleanout: El Existing ➢Y Ftew Installation
Comments and/ or
Sketch:
Test Type: Water ❑ Air
Status: X Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
Partial Repair Made 10 Year ❑
New Installation 25 Year