HomeMy WebLinkAbout1007 Morrell Avenue - SL - 2023.02.16 - 25 YearsO�UjlUj4GAME
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address: 1001 Mo Vro ( gekue Tested Date: 02 I IG I Z-3
Owner: P 0S a K a 014 Building Permit#: r -.3 - UU I f
Contractor Name: S i,,<,1�i MCts ��U4r„btl�q Encroachment Permit#: ?W -L'S - o03 Z
City Staff Name: :Sc, ISL (TJ nZ� l �$
Cleanout Location: ❑ Front 4n Rear ❑ Left ❑ Right
Face of Curb
Lateral Size: H 4
Cleanout: ❑ Existing J2' New Installation
Comments and/ or
Sketch:
Test Type: IE!r Water ❑ Air
Status: -Zl' Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year ❑
Partial Repair Made
10 Year ❑
New Installation
25 Year -�