HomeMy WebLinkAbout1601 Hillside Drive - SL - 2024.05.10 - 25 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
IAddress:
Owner:
Conlroclor Nome:
Cily Stoff Nome:
Tesled Dole:
Building Permil #:
Encroochment Permil #:
s
Cleonoul locolion:I Front tr Left ,( nignttr Rear
Foce
[olerol Size:
Cleonoul:
Comments ond/ or
Skelch:
Tesl Type:Woler tr Air
Slolus:E/ pott tr Foit
Sewer Lateral Condition:
No 10 Year
Mode 10 Year D
>K
\Existing tr New tnstallation
Portiol
lnslollotion 25 Year 2(