HomeMy WebLinkAbout1046 Laguna Avenue - SL - 2022.10.28 (25)Address: it -)L- (b L—(,(2 IJ✓\. O1
Owner:
Contractor Name:
c
City Staff Name: M
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date:
Building Permit#: � �L Ur\L4
Encroachment Permit#: ' I
Cleanout Location: ❑ Front
—Z< Rear
Left
❑
Right
Face of Curb
Lateral Sze:
Cleanout: Existing ❑ New Installation
Comments and/ or
Sketch:
Test Type: gyp\ Water ❑ Air
Status: Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
Partial Repair Made 10 Year ❑
New Installation 25 Year