HomeMy WebLinkAbout889 California Drive - SL - 2022.10.25 - 10 Yearsa
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Address: IM
Owner: Vs Kr'TfCI QovP43ITIt5 U,L
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: 101 Z S 1 tiZ
Building Permit #:
Contractor Name:-I[VIRL Encroachment Permit #: pwyl - b(,f),7,
City Staff Name: —1~V PA`41�1YA
Cleanout Location: ❑ Front lff Rear ❑ Left ❑ Right
Face of Curb
Lateral Size:
Cleanout: [2 Existing ❑ New Installation
Comments and/ or
Sketch:
Test Type: 7o Water ❑ Air
Status: Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year 4ff
Partial Repair Made
10 Year ❑
New Installation
25 Year 0