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29 Humboldt Road - SL - 2024.12.17 - 25 Years
City of Burlingame Public Works Department Sewer Lateral Test Certificate Address: Owner: Conlroclor Nome: Cily Stoff Nome: 2q H.rtalor\lt 0-o*[ ll,fJrn^ Sgtt Tesled Dole: Building Permil #: Encroochment Permit #: ! Left PIP co,":truct-ia rt N\^o gutovl.\ Cleonoul Locolion:\rront tr Rear tr Right toce ot Curb Lolerol Size: Cleonoul: Commenls ond/ or Skelch: .t tl 6 Existing Test Type: Stotus: Sewer Lateral Condition: No Repoir Needed Portiol Repoir Mode New lnstollotion tr Air tr Foir Exemption Type: 10 Year tr 10 Year ! 25 Year lf a a Woter Poss i tz lrr lza Bz-t- oo3S