HomeMy WebLinkAbout1400 Burlingame Avenue - SL - 2015.01.02 - 25 YearsIt of Burlingame
RLIRGA,ME
k, Public Works Department
J
Sewer Lateral Test Certificate
Adclress; Tested Date:
--'k
Owner: Building Permit #: _c,
Contractor Name:
Encroachment Permit 0
City Staff Name:
Cleanout Location: 0 Front 0 Rear El Left El Right
Face of Curb
1 77-1
Lateral Size:
Cleanout: El Existing New Installation
Test
Status: Pass ❑ Fall
Sewer Lateral Condition:
Exemption Type:
Na Repair Needed
10 Year._...... El
...... .. ... .
,fortialRepair Made
-----------
10 Year El
New gnstallation --- - - - --------
25 Year