HomeMy WebLinkAbout1312 Sanchez Avenue - SL - 2023.06.20 - 25 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:t-1 ut GI �%tCS I.t
-� Tested Date:
Owner: � Building Permit #:
Contractor Name: `�"�_ W� J �,( �.i �' Encroachment Permit #:
City Staff Name:
Cleanout Location: Front ❑ Rear ❑ Left
Lateral Size: L,.t
Cleanout: ❑ Existing LT N Installation
Comments and/ or
Sketch:
❑ Right
Test Type: W'ater ❑ Air
v
Status: 0 / Pass ❑ Fall
Sewer Lateral Condition:
_ No Repair Needed
Partial Repair Made
New Installation
Exemption Type:
10 Year ❑
10 Year ❑
25 Year