HomeMy WebLinkAbout1528 ALturas Drive - SL - 2023.03.14 - 10 YearsAddress:
❑
Front
ig Rear
Owner:
�J \i'GX W1V
�/K'tln
(.1n TYLIA' f�1nIW �.I MOn'7(
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: 4>1 YN 1 2,3
Building Permit#:
Contractor Name: _C IS1,IAA,K 'VW6Ylfij1 test& Encroachment Permit#: ?W'1 -j- U01 Ii
City Staff Name: T?W\t7 eA"1-17t>rA
Cleanout Location:
❑
Front
ig Rear
❑
Left
❑
Right
Face of Curb
Lateral Sze: LI If
Cleanout: it Existing ❑ New Installation
Comments and/ or
Sketch: WATT/k-cr/ 6;; ,�P.
Test Type: Ur Water ❑ Air
Status: V Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Pa air Needed 10Year J31, -
Partial Re
31,-Partials air Made 10Year ❑
New Installation 25 Year 0