HomeMy WebLinkAbout907 Paloma Avenue - SL - 2022.10.25 - 10 Years�9
Address:
Owner: P1JGl�A �u�+ct-> Qi'T"N Wd/11,FtC kF.PfT1�10�
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: 10 11,0 'i2
Building Permit #:
Contractor Name: 'M 5V D 1Atx OUAYt (7,tJb Encroachment Permit
City Staff Name: hM\n ( A iX)U A
Cleanout Location:
Front
❑ Rear
❑
Left
❑
Right
Face of Curb
It
Lateral Size:
Cleanout: Ea Existing ❑ New Installation
Comments and/ or
Sketch:yy i't-1. TP
Test Type: 4a Water ❑ Air
Status: ❑ Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year JR
Partial Repair Made 10 Year ❑
New Installation 25 Year 0