HomeMy WebLinkAbout1127 Eastmoor Road - SL - 2023.07.06 - 10 YearsAddress: � � rVI C hs -F Yt o 0'N 'PV
Owner: _PbTCS SM'bAf1 * QjMAD�f
Contractor Name: AvAsA Grab\NQ ,(sJb
City Staff Name: D f j1S7 Cpp(L-Vo r� f4
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: 7 )6 ) V7
Building Permit #:
Encroachment Permit #: Qw qL3, —01-4-61
Cleanout Location:
Front ❑ Rear
❑ Left
❑
Right
10 Year
Face of Carb
Partial.Repair Made
20 Year ❑
New Installation
25 Year ❑
Lateral Size:
�,1
` _ —
Test Type:____
Water
❑ Air
Cleanout:
12 Existing ❑ New Installation
Status:
t2l Pass
❑ Foil
Comments and/ or
Sketch:
Sewer Lateral Condition:
Exemption Type:
No Repair Needed_
10 Year
Partial.Repair Made
20 Year ❑
New Installation
25 Year ❑