HomeMy WebLinkAbout758 Walnut Avenue - SL - 2022.10.18 - 10 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address: -76A W*Lr°IA.T /t'r'Gi. Tested Date: 1011c �zz
Owner: 1 St: WA-t.r'1AS Itif-, ),LL. Building Permit #:
Contractor Name: 121 Si -014-,K PUAn! lJ,>6 1VL. Encroachment Permit#: PW9.2.,- 6)57'5
City Staff Name: Dh-vt i 11-h-4-1>Dt-A
Cleanout Location:
91 Front
❑ Rear
❑
Left
❑
Right
Face of Curb
Lateral Size:
Cleanout: J1 Existing ❑ New Installation
Comments and/ or
Sketch: rr AIV,J- TF $-V JA66,2 J
Test Type: Dd Water ❑ Air
Status: yo Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year
Partial Repair Made 10 Year ❑
New Installation 25 Year ❑