HomeMy WebLinkAbout1350 Burlingame Avenue - SL - 2015.01.02 - 25 YearsCITY
City of Burlingame
URLIMA*
Public Works Department
Sewer Lateral Test Certificate
Address:s. Tested Date:
Owner: Building Permit #:
Contractor Name: Al, Encroachment Permit #: ICA
City Staff Name:
Cleanout Location, El Front UJ Rear Left ❑ Right
17 Face a f Curb
y Lk
Cleanout: El Existing New Instillation
Test Type: Water ❑ Air
Status: Pass ❑ Fall
Sewer Lateral Condition:
Exemption Type:
No Reperkyee-deld-
10 Year
Partial Repair Made
10 Year El
New Installation
25 Year