HomeMy WebLinkAbout1100 Mills Avenue - SL - 2022.09.22 (10)j �, clrr o
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Address: 111,10 !4 1LLS .MAc
Owner: bNG > 1 ilJKr' (,A4 VA�) ii 1'N
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date:
Building Permit #:
Contractor Name: D15f.v,^J-, PLInvt Aat JL Encroachment Permit#: PVJ 2-1, - ()5'1-7
City Staff Name: DA./1O LA4M%k-)fq-
Cleanout Location: ❑ Front ❑ Rear ❑ Left Right
Face of Curb
r V
Lateral Size:
Cleanout: 0 Existing ❑ New Installation
Comments and/ or rr `
Sketch: WAIV,i4-
Test Type: 0 Water ❑ Air
Status:
Pass
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year �7
Partial Repair Made 10 Year ❑
New Installation 25 Year ❑