HomeMy WebLinkAbout1118 Marquita Avenue - SL - 2023.05.04 - 10 YearsCommentsand/ or
Scetch:
Sewer Lateral Condition: Exemption Type:
No F9 air Needed 10 Year Jp
Partial Repair Made 10 Year ❑
New Installation 25 Year 13
City of Burlingame
e
Public Works Department
Sewer Lateral Test Certificate
Address:
,1 11Z MA-Q-GtLI
ITA nJ
Tested Date: sI L I23
Owner:
-TAIXAVL1
Building Permit#:
Contractor Name:
".SVILLANP
t�lJbtr���P��r-.SLS
�?t�i,n t'1 Oj�J�.
Encroachment Permit#: IPW 01L�L,i `
City Staff Name:
i7A-/xn fRiliS7ti.-S�
Cleanout Location:
❑
Front
Rear
❑ Left ❑ Right
Face of Curb
Late raI Sze:
N
Test Type: '¢3 Water ❑ Air
Cleanout:
1�r Existing
❑ New installation
Satus: Pass ❑ Fail
Commentsand/ or
Scetch:
Sewer Lateral Condition: Exemption Type:
No F9 air Needed 10 Year Jp
Partial Repair Made 10 Year ❑
New Installation 25 Year 13