HomeMy WebLinkAbout1429 Burlingame Avenue - SL - 2015.01.02 - 25 YearsLit2L INGAME
Public
1 Department
Sewer Lateral Test Certificate
Address: Tested tate:
Owner: Building Permit #:
Contractor Name. Encroachment Permit #:
City Stan Name: kL
Cleanout Location: ® Front
F1 Rear
❑ Lett
❑
Right
10 Year El
Fore of Curb
25 Year
ri
Lateral Size:(Test T Water Air
._....... .... w_.
-- Type:
Cleanout: El Existing New Installation Status Pass ❑ Fail
Comments and/ or t
Sewer Lateral Condition
_
_ Exemption Type.
..___ Nolte Needed
10 Year ❑
Partial Repair"iade
10 Year El
New Installation
25 Year