HomeMy WebLinkAbout734 Linden Avenue - SL - 2022.10.25 (25)City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address: F.� rV 'fS "E Tested Date: A
Owner: C� Building Permit#:
Contractor Name: ui-t; *✓C Encroachment Permit*%t%Za--"IfJ
City Staff Name: "II�DIC *3
Cleanout Location: X Front ❑ Rear )< Left ❑ Right
Face of Curb
Late raI Sze: r Test Type: /Water ❑ Air
Cleanout: ❑ Existing New Installation Status: Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
Partial Fleair Made 10 Year ❑
New Installation 25 Year