HomeMy WebLinkAbout1217 Burlingame Avenue - SL - 2015.01.02 - 10 YearsCITY"
City of Burlingame
Public Works Department
No Repair Needed
Sewer Lateral Test Certificate
Partial Repair Made
10 Year
Address:
j Tested Date
Owner:
Building Permit #:
ContractorName: t E
Encroachment Permlt M
Cleanout Location: ❑ Front ❑ Rear ❑ Left ❑ Right
Fa c e of Curb
Lateral Sze:
Cleanout: ❑ Existing ❑' New Installation
Test Type: 41) Water ❑ _ Air
Status: Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year ❑
Partial Repair Made
10 Year
New Installation
25 Year