HomeMy WebLinkAbout2812 Rivera Drive - SL - 2023.06.27 - 10 YearsAddress: 9'\11' .p A N)4,,
Owner: W`Il1F 2Ay ?4N UWV,&A V-UVLA
Contractor Name: FI/C'(Ly [)� 646AT2y (,j2e`7'U i (SU,i W t
City Staff Name: 10Rv\7 �,PL1�L7u N/d
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: _& 11_1 123
Building Permit #:
Encroachment Permit #: ?W1_$- O `L`1 �_
Cleanout Location: Front ❑ Rear ❑ Left ❑ Right
Foce of Corb
Lateral Size: 1 Test Type_ Water ❑ Air
Cleanout: 16 Existing ❑ New Installation
Comments and/ or ,,nn
Sketch:
Status: I Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year
Partial Repair Made
10 Year ❑
New Installation
25 Year ❑