HomeMy WebLinkAbout1472 Drake Avenue - SL - 2023.07.27 - 10 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:
��7'L �(t/{\\! C_ AVQ .
Tested Date:
-] 111' 23
Owner:
C.Pt�`L$D N Ly Nt•1 G k TN
Building Permit #:
Contractor Name:L\N�S'roi()N1
'LL7Y1 {t`j
Encroachment Permit #:
City Staff Name:
\7Pw \7
Cleanout Location:
❑ Front Rear
❑ Left
❑ Right
Face of Curb
L1Y
Lateral Size:
Test T e_
Water ❑ Air
Cleanout:
_A51 Existing ❑ New Installation
Status:
Pass ❑ Fail
Comments and/ or
Sketch:
Sewer Lateral Condition: Exemption Type:
No Repair Needed 10 Year
_
.,-Partial Repair Made---- 10 Year __ ❑
New Installation 25 Year ❑