HomeMy WebLinkAbout953 Paloma Avenue - SL - 2023.08.03 - 10 YearsAddress: "1rJ7 ?/N�-VM)'c
Owner: -LO-A TMk - � h11Al.YA
Contractor Name: 'QVAAt'lQ1Jh
City Staff Name: `DNL2 UdleZAA-3A
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: $ -311-3
Building Permit #:
Encroachment Permit #: PW 2,3 - G 3 -A V
Cleanout Location: ❑ Front Rear ❑ Left ❑ Right
Face of Curb
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Lateral Size: t�
Cleanout: C] Existing ❑ New Installation
Comments and/ or `^ ,.�.-
Sketch: W/4T�itli �i VsS`r �I
Test T pe: V Water ❑ Air
Status: 0 Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year
Partial Repair Made 10 Year ❑
New Installation 25 Year 0