HomeMy WebLinkAbout270 Chapin Lane - SL - 2023.02.21 - 10 YearsComments and/ or �r
Sketch: �OP�I.C'✓' kogs�
Sewer Lateral Condition: Exemption Type:
NoPaair Needed 10 Year
Partial Pa air Made 10Year ❑
New Installation 25 Year 13
City of Burlingame
Public Works Department
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Sewer Lateral Test Certificate
Address:
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Tested Date:
Owner:
U(1 1 S GU
PrE-� ::58t-
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Building Permit#:
Contractor Na me:
V-LyER..
Encroac hment Permit#: rAL,f��-�Cj��p
City Staff Name:
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Cleanout location:
'ZI Front
❑ Rear
X Left ❑ Right
Face or Curb
[t
Late ral Sze:
Test Type: ><Water ❑ Air
Cleanout:
>11� Existing
❑ New Installation
Status: Pass ❑ Fail
s
Comments and/ or �r
Sketch: �OP�I.C'✓' kogs�
Sewer Lateral Condition: Exemption Type:
NoPaair Needed 10 Year
Partial Pa air Made 10Year ❑
New Installation 25 Year 13