HomeMy WebLinkAbout1453 Bernal Ave - SL - 2020.10.09 - 25 yearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:
Owner:
Conlroctor Nome:
Clly Stoff Nome:
Tesled Dote:
Building rermir *: 6t 1-mnn
Encroochmenl Permil #:
D'4 . C^v^. \,.-,
Cleonoul locollon:I Front ts-'"r,tr Left tr Right
lolerol Size:
Cleonoul:
Commenls ond/ or
Skelch:
( existing n New tnstallation
Tesl Type: ?(. wot.,n AiI
Slolus:'I5( port tr
Sewer Lateral Condition:
Foil
No Repok Needed 10 Year tl
Porliol Repok Mode 10 Year tr
New lnslollolion 25 Year .{
1463 R -^r^lu