HomeMy WebLinkAbout251 Park Road - SL - 2025.04.22 - 25 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test icate
Tesled Dote:4 5Address:
Owner:
Controctor Nome:
Cily Sloff Nome:
OoBuilding Permit #:
Encroochmenl Permil #:T.
Cleonoul [ocollon:{r.ont n Rear n Left n Right
toterol Size:
Cleonoul:
Commenls ond/ or
Skelch:
;EL e*i.Ung tr New tnstatlation
TeslType: X wot",n Air
Slolus:ffio,,n Foit
Sewer Lateral Condition:
No Repoh Needed lOYear n
Porliol Repoir Mode 10 Year El
New lnslollotion K25 Year
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