HomeMy WebLinkAbout1132 Drake Avenue - SL - 2023.06.27 - 10 YearsC17Y
BU/2LINGAME
Address: 1131- 1WAVNf-
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: 6127 11,3
Owner: %EA L Building Permit #:
ContractorName: (.G - .�(��S'SILIA/"\ 6� \ N (, Encroachment Permit #: Vwq-s - U"ii S
City Staff Name:
Cleanout Location: ❑ Front
M Rear
❑
Left
❑
Right
Face of Curb
Lateral Size: I
Cleanout: E9 Exisfing ❑ New Installation
Comments and/ or
Sketch:
Test Type: Water _ ❑ Air
Status: _ '� Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year M
Partial Repair Made 10 Year ❑
New Installation 25 Year 11