HomeMy WebLinkAbout1046 Laguna Avenue - SL - 2022.10.27 - 10 YearsnU
Address: kb�Ab LA6iA,>A PNv
Owner: VAIAArj-4 4A'5Vft0 -1124-40Y) W- 0\ Wtf,-
ContractorName: M\- t6 'P\,LA M b tet. Y i(!•ll(KT::L
City Staff Name: VI-A'Z? CA4,T) pr
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: ';J'
Building Permit #:
Encroachment Permit #:
Cleanout Location: ❑ Front sp Rear ❑ Left ❑ Right
Face of Curb
Lateral Size:
Cleanout: 'Q Existing ❑ New Installation
Comments and/ or
Sketch: w � 'S"'FhS `(1/�'y�j17, 1`� vATrj—
LujS .
Test Type: 19 Water ❑ Air
Status: Or Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year ❑
Partial Repair Made
10 Year EP
New Installation
25 Year ❑