HomeMy WebLinkAbout140 Myrtle Road - SL - 2023.05.30 - 25 YearsAddress:
Owner:
Contractor Name:
City Staff Name:
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date:(- f0 -;,7 5
Building Permit It: ..yy: /� --0 7�
Encroachment Permit #: rPO 2 ✓-O
Comments and/ or
Sketch:
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
_
Partial Repair Made 10 Year ❑
New Installation 25 Year
Cleanout Location:
Front ❑ Rear
❑ Left
❑
6
Right
Face of C o r b
Lateral Size:
_
Test Type:
,Water
❑ Air
Cleanout:
,�/v
El Existing J� New Installation
Status:
r
___gKPass
_
❑ Fair
Comments and/ or
Sketch:
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
_
Partial Repair Made 10 Year ❑
New Installation 25 Year