HomeMy WebLinkAbout717 Farringdon Lane - SL - 2023.06.27 - 25 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:
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Tested Date:
Owner:
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Building Permit #:
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Contractor Name:
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Encroachment Permit #:
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City Staff Name:
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Cleanout Location:
,Front ❑ Rear
❑ Left
❑ Right
face of Curb
Lateral Size:
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Test Type:
Water ❑ Air
Cleanout
❑ Existing New Installation
_ Status _ X
Pass ❑ Fail
Comments and/ or
Sketch:
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year ❑
Partial Repair Made 10 Year ❑
New Installation 25 Yearzoo