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475 Chatham Road - SL - 2023.05.25 - 10 Years
Address: 1-115 GNA't1aR�n Q,D Owner: SELG"�,k 711Ft -5L Y11,055A Contractor Name: xD CFC, U21JSrT0,1 AIXNp> \\�L City Staff Name: "t)^ -41—j> %/C:tiiit�Nftf City of Burlingame Public Works Department Sewer Lateral Test Certificate Tested Date: 'j /2S J 23 Building Permit #: Encroachment Permit #: py)y'j - o \ (� t( Cleanout Location: [g Front ❑ Rear Face of Curb ❑ Left ❑ Right Lateral Size: �t tA,c __ _ __ -__. I _ _Tes1T e: L7 Water ❑ Air Cleanout: 19 Existing ❑ New Installation Status: Pass ❑ Fail Comments and/ or Sketch: _ ._WKS T�4- _ T4J7S �AC`�7\iii •.-_.__. __.-_. Sewer Lateral Condition. Exemption Type: No Repair Needed 10 Year f8' Partial Repair Made 10 Year ❑ New Installation 25 Year 11