HomeMy WebLinkAbout1209 Grove Avenue - SL - 2023.06.08 - 10 Years', CITY
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BURLINA
GME
Address: 1 ZO 91 (> ro Ate_
Owner: J Z�Vn UO -5s �— —
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Contractor Name: J e.S aurc
City Staff Name: ;A • /k2St Jot,,
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City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: (0-8-2-3
Building Permit #:
Encroachment Permit It: 1'4)Z3^ <3 ZZ -s
Cleanoat Location: 11iL Front ❑ Rear ❑ Left ❑ Right
'�'(Ij Face of Curb
Lateral Size: Test Type: ML Wafer ❑ Air
Cleanout: K Existing ❑ New Installation
Comments and/ or /� (� ' . ` ^/,.,
Sketch: �'\SJ_ IL�4. r Q�%/` dLs.+"n- d
Status: all Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:,
No Repair Needed 10 Year Its
Partial Repair Made 10 Year ❑
New Installation 25 Year ❑