HomeMy WebLinkAbout2010 Trousdale Drive - SL - 2022.12.19 - 25 YearsCity of Burlingame
B"R�"°AME Public Works Department
Sewer Lateral Test Certificate
Address: —:7-0/0 /*rte -a t1 r& Tfz— Tested Date: /Z' / /,—Z'
Owner: Building Permit#:
ContractorName:
ING Encroachment Pe rmit#:
City Staff Name: /"t
Cleanout Location: El Front ❑ Rear ❑ Left ❑ Right
Face of Curb /
Lateral Size: Test Type: O Water ❑ Air
4 1YCleanout: ❑ Existing New Installation Status: Pass 13 Fail
Commentsand/ or
Sketch:
Sewer Lateral Condition: Exemption Type:
No Paair Needed 10 Year ❑
Partial Pe air Made 10Year ❑
New Installation 25 Year