HomeMy WebLinkAbout1017 El Camino Real - SL - 2023.03.16 - 10 YearsAddress:+0 \-11—t E\, G/q�t'\\ND
Owner: TUI \GK )V\Ao ) -o— (1A11(t� )b�lrl
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: -0 it, Z3
Building Permit#:
Contractor Name: )n Encroachment Permit#: "1 1-3 - DU C13
City Staff Name: CA"OSA
Cleanout Location:
Front
❑ Rear
❑
Left
❑
Right
Face of Curb
Lateral Sze:
Cleanout: M Existing ❑ New Installation
Commentsand/ or
&etch: w%1TVA,- -gNMfzv^n7 t-�IJ VjAn--SV UJCi'S
Test Type: )7 Water ❑ Air
Satus: X Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year X
Partials air Made 10 Year ❑
New Installation 25 Year 11