HomeMy WebLinkAbout1294 Burlingame Avenue - SL - 2015.01.02 - 25 YearsLUM a 1-61 M H =-.
Sewer Lateral Test Certificate
Address: Tested Date: �7A-z�z
Owner: Building Permit #:
Contractor Name:
Encroachment Permit #: S-Eb
City Staff Name: \4-0 A4a
Cleanoul Location; 0 Front
Face o I Curb -
4 u r b
-�- 0 M= -
Cleanout: Existing New Installation
Comments and/ or
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Test Type: Water Cl Air
Status, PassEl Fail
- ---------- - -
Ywer Lateral Condition:
Exemption Type:
Pio Repair 'Needed
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25 Year