HomeMy WebLinkAbout3040 Alcazar Drive - SL - 2023.03.07 - 10 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address: SOHO A LGA z A (t DC- Tested Date: 3 /2-3
Owner: Mrd€-ArztAmE AMM- C 7e— Building Permit#: z
Contractor Name: '11) Cc-SAfc C�>/.s S'7Y-V C -n o� Encroachment Permit#: �5.�2-3 DD $ 3
City Staff Name: OVWJ "AILOP-Tia Lt LIf A-C.O
Cleanout location:
9K Front ❑ Rear
Face of Curb
❑ Left
❑ Right
Lateral Sze:
Test Type:
19Q Water ❑ Air
Cleanout:
Existing ❑ New Installation
Status:
(qp Pass ❑ Fail
Commentsandl or I ���r-„�/-Tr--,
Ty n /�
Sketch: 0 '1. 1G -T PN{S C'o
Sewer Lateral Condition: Exemption Type:
No P --pa ir Needed 10 Year
Partials air Made 10 Year ❑
New Installation 25 Year 11