HomeMy WebLinkAbout818 Acacia Drive - SL - 2022.10.03 (25)-G
BURIJNGAFtE
Address:
Owner:
Contractor Name:
City Gaff Name:
Cleanout Location:
Front
v
Lateral Sze: OE
Cleanout: ❑ Existing New Installation
Commentsand! or
S<etch:
❑ Rear
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: W'�
Building Permit#: 431---00—
Encroachment Permit#:
❑ Left ❑ Right
Sewer lateral Condition:
Exemption Type:
TestType:
Water
❑
Air
New Installation
25 Year
Status:
Pass
❑
Fail
Sewer lateral Condition:
Exemption Type:
No Repair Needed
10 Year ❑
Partial Repair Made
10Year ❑
New Installation
25 Year