HomeMy WebLinkAbout1120 Cortez Avenue - SL - 2022.10.06 (25)Address: I iL,V
Owner
Contractor Name:
City Staff Name: t
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: LU O
Building Permit #: U ✓�
Encroachment Permit #: I
Cleanout Location: ❑ Front Rear Left ❑ Right
Face or Curb
Lateral Size:
Cleanout: ❑ Existing
Comments and/ or
Sketch:
New Installation
Test Type: � Water ❑ Air
Status:
❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
Partial Repair Made 10 Year ❑
New Installation 25 Year