HomeMy WebLinkAbout1361 Edgehill Drive - SL - 2005.08.01City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:
Owner:
Conlroclor Nome:
Cily Sloff Nome:
Cleonoul tocolion:
136-l E tq \^ " \\R-r. ()5Tested Dote:
Encroochmenl Permil #:
I Front D Rear n Left D Risht
Foce of
lolerol Size:
Cleonoul:
Commenls ond/ or
Skelch:
D Existing )Xi *"* tnstattarion
Tesl Type:2( *o,",D Air
Slotus:H oo*tr Foit
Sewer Lateral Condition
No Needed 10 Year D
Portiol Repolr Mode 10 Year
New 25 Year
Buildingr"r-nO'M
tr