HomeMy WebLinkAbout891 California Drive - SL - 2022.11.08 - 10 YearsAddress: %,I 'Ty,
Owner: 'a's 'Ck.,K1 Qt"Nj/tN"
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: I I I Y I tit
Building Permit #:
Contractor Name: f„)b) Encroachment Permit #: --vj v2 - M 0
City Staff Name: TYty 10 PJA,t,x.) /A
Cleanout Location: ❑ Front ❑ Rear ❑ Left ❑ Right
Face of Curb
Lateral Size:
Cleanout: ® Existing ❑ New Installation
Comments and/ or
Sketch: TN/CS%A- '�h5 �l imp_ W ',JA -K -J— UY5C
Test Type: J?J Water ❑ Air
Status: M Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
Partial Repair Made 10 Year
New Installation 25 Year ❑