HomeMy WebLinkAbout2408 Hillside Drive - SL - 2023.03.10 - 25 YearsCity of Burlingame
BURLItJGAME Public Works Department
Sewer Lateral Test Certificate
Address: ZL4 \l5%�-C- Tested Date: 3A0/,'3
Owner: ilA'. w. -I FJ Building Permit #: P23 ' 0025
Contractor Name: 5 . t� r e S -L (,T, Encroachment Permit #: PW Z 3 ' 0075
City Staff Name: j a\!tt C9 ova ZY �q
Cleanout Location: ❑ Front ❑ Rear ❑ Left ❑ Right
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Face of Curb
Lateral Size: 0 �,
-Cleanout: ❑ Existing j[r New Installation
Comments and/ or
Sketch: C�C^�aJ\r .y- !o:-/ °(kid.
t`2V.> MLtti ws't QW L �LvG
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Test Type: ,.r water ❑ Air
Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
Partial Repair Made 10 Year ❑
New Installation 25 Year