HomeMy WebLinkAbout201 Burlingame Avenue - SL - 2022.10.18 - 10 Years9
Address: ?zQl AA,
Owner: S2.kAY4-t' K. &-^V ? (,E"R
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: 10 i i ti l L-1-
Building
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Building Permit #:
Contractor Name: \j( -U IA JT ?UAVt(h),�,L- V>b. Encroachment Permit#: PW%z-b45t-7
City Staff Name: L)M(K7 (',JWKV>A\
Cleanout Location: '® Front ❑ Rear ❑ Left ❑ Right
Face of Curb
Lateral Size:
Cleanout: 9 Existing ❑ New Installation
Comments and/ or
Sketch: VXIN1 - "�'j,C DA-SS:/n7 mai LFc�
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Test Type: Water ❑ Air
Status: Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year 17
Partial Repair Made 10 Year ❑
New Installation 25 Year ❑