HomeMy WebLinkAbout3088 Alcazar Drive - SL - 2023.02.21 - 25 Years_FyJ,Ir�yCr.'I1f�T���:Yx9n�a
UURLiNGA ME
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address: 3&H A%c,,LG( Tested Date: 0-t J tl 1 2,31Owner: 54y, k- L 7veS Building Permit #: P'L3 - Uu 1 3
Contractor Name: ,� , b • cOLSV-yd c YI tit^ Encroachment Permit #: PJ�'1 oSS�
City Staff Name: SS K"C. L -S
Cleanout Location: ❑ Front
'Er Rear
-El' Left
❑
Right
'Er- Pass
Face of Curb
Fail
Partial Repair Made
10 Year ❑
New Installation
25 Year -8
1,
Lateral Size:
Cleanout: ❑ Existing El- Newlnstallation
Comments and/ or
Sketch:
Test Type:
Water
❑
Air
Status:
'Er- Pass
❑
Fail
Sewer Lateral Condition:
Exemption Type:
No Re air Needed
30 Year ❑
Partial Repair Made
10 Year ❑
New Installation
25 Year -8