HomeMy WebLinkAbout1236 Burlingame Avenue - SL - 2015.01.02 - 25 YearsCITY,City of Burlingame�
BURT tNGAR#
Public Works Department
Sewer Lateral Test Certificate
r.w .
Address: ry.'"; . _ Tested tate;
Owner: � Building Permit #;
Contractor Name: a Encroachment Permit
City Staff Name;
Cleanout Location: ❑ Front ❑ Rear ❑ Lett ❑ Right
Face of Curb
Lateral Size: .a
Cleanout: ❑ Existing New Installation
Test Type: Water ❑ Aar
Status. Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year ❑
Partial Repair Mode
10 Year ❑
New Installation
25 Year