HomeMy WebLinkAbout716 Concord Way - SL - 2023.05.02 - 10 YearsI fBURLIN6AME
Address: —11 1� CUtV i.' fl_n W&4
Owner. MACIAMANN 'nL
Contractor Name: V-We-lft' F1JPctNrF>J )yJ(i
City Staff Name: phd I'> CRiZOUt-NF1
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: sl ZI ?-I
Building Permit#:
Encroachment Permit#: ?\44111 -0)-)[)
Cleanout Location:
Exemption Type:
Front
❑ Rear
❑
Left
❑
Right
New Installation
25 Year ❑
Face of Curb
Lateral Sze: Li It
Cleanout: 'Z Existing ❑ New Installation
Commentsand/ or
Sketch:
W^i'E, )� lil)cj -
Test Type: KI Water ❑ Air
Status: *Pl Pass
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year 39
Partial Pe air Made
10 Year ❑
New Installation
25 Year ❑