HomeMy WebLinkAbout1427 Burlingame Avenue - SL - 2015.01.02 - 25 Years%City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:
-
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—As1
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Tested Date:
Owner:
Status:
New Installation
Building Permit
Encroachment Permit #:
Contractor Name:
City Staff Name:
Cleanout Location: ❑ Front 0 Rear ❑ Left ❑ Right
Face of Curb
LoteralSize:
Cleanout: ❑ Existing New Installation
Comments and/ or
tch�
Test Type:
Exemption Type:
Water
... . . .....
❑
Air
Status:
New Installation
Pass
❑
Fail
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year El
'Partial Repair Made
1(t Year
New Installation
25 Year