HomeMy WebLinkAbout1124 Drake Avenue - SL - 2022.11.03 - 10 YearsC
BURLIrjGAME
Address:
Owner:
Contractor Name: o 94CL I
City Staff Name:
City of Burlingame
Public Works Department
//11 Sewer Lateral Test Certificate
A�- Tested Date:
f— lore 10.T Building Permit #:
✓15 rLr.� I� h Encroachment Permit #: P 6 J 2.L -06 1 t
Cleanout Location: ❑ Front Rear ❑ Left ®- Right
Lateral Size:
Cleanout:
Comments and/ or
Sketch:
1 v')
[, Existing ❑ New Installation
e6,n �+on&r- de<k
Test Type: 111 Water ❑ Air
Status: 21- Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year
❑
Partial Repair Made
10 Year
❑
New Installation
25 Year
❑