HomeMy WebLinkAbout1652 Lassen Way - SL - 2023.04.24 - 25 YearsAddress:
Owner:
Contractor Name:
City Staff Name:
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date:
+21, 23
Building Permit #: / Gq ,y0'aI
Encroachment Permit #: KPJ LS �
Comments and/or
Sketch:
Sewer Lateral Condition:
No Repair Needed
Partial Repair Made
New Installation
Exemption Type:
10 Year ❑
10 Year ❑
25 Year
Cleanout Location: Front ❑ Rear
❑ Left
❑
Right
Face of Curb
Lateral Size:
Test Type:
Water
❑ Air
Cleanout: ❑ Existing 'New Installation
Status:
WPass
_
❑ Fail
Comments and/or
Sketch:
Sewer Lateral Condition:
No Repair Needed
Partial Repair Made
New Installation
Exemption Type:
10 Year ❑
10 Year ❑
25 Year