HomeMy WebLinkAbout1135 Drake Avenue - SL - 2023.03.28 - 10 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address: \\'1)5 T)O-XV« Avf Tested Date: 3 &q ) 23
Owner: IAANO(7.41� W)bVIA-0 T,(L, fO"-4 C yNT131A Building Permit#:
Contractor Name: L1r,-11)gTQ.0y1 C4)opn.3�/ Encroachment Permit#: DW ji"!j- (711v1
City 3aff Name: 01,V-411) s -@gyp 00A.
Cleanout location: ❑ Front V Rear ❑ Left ❑ Right
Face of Curb
Lateral Sze:
Cleanout: ❑ Existing ❑ New Installation
Commentsand/ or
Sketch: M�h'1'F„ ll� SC'i]t �haSS'ai
Test Type: 0 Water ❑ Air
Status: 10 Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No F'e air Needed 10 Year
Partial Repair Made 10 Year ❑
New Installation 25 Year ❑