HomeMy WebLinkAbout1605 Marco Polo Way - SL - 2022.12.15 - 10 YearsASE CITY O�
BUR LINGAME
Address: i 6 US MM+-t,o PU L o VJ"
Owner: 004-1 T1NLb1-Tiy 'Yr Kk('Ytt.�ir�
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: t% I t r / 2 Z
Building Permit #:
Contractor Name: ATti/sg i)UTA.M 20 J& )4 Encroachment Permit#: PVJti%'(i6
City Staff Name: 'O/c41O CA-gi-)/a� t
Cleanout Location:
E9 Front
❑ Rear
❑
Left
❑
Right
New Installation
Face of Curb
Lateral Size:
Cleanout: V Existing ❑ New Installation
Comments and/ or 'Ni JI PA
Sketch:
Test Type: D1 Water ❑ Air
Status: ta Pass ❑ Fall
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year
Partial Repair Made
10 Year ❑
New Installation
25 Year ❑