HomeMy WebLinkAbout1030 Chula Vista Avenue - SL - 2022.10.11 - 10 YearsM
Address: GWvtL A YDS A /K1=
Owner: (;/k1.f Y1 /tl�� �;4 Ty, /r
Contractor Name: (>A ,X IJ(,
City Staff Name: D/c'\ T7 ln^-C'+)WA
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: iU I Ia f -ZZ-
Building Permit #:
Encroachment Permit It: N'%2- o(:�ry-\
Cleanout Location: ❑ Front ® Rear ❑ Left ❑ Right
Face of Curb
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Lateral Size:
Cleanout: 151 Existing ❑ New Installation
Comments and/ or
Sketch: �nfKl"F1t- 'iCiSS hh'�iLG7 rel) W/}1Yt� l.U.
Test Type: Water ❑ Air
Status: Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year
Partial Repair Made 10 Year ❑
New Installation 25 Year 0