Summary of Lead Service Line Inventory - LSLI_NY0041407 (NY0419671)

I. System Information

Water System Name LSLI_NY0041407
PWS ID Number NY0419671

II. Contact Information for Owner / Licensed Operator of Record Completing the Form

Contact Name Gary Kepp
Contact Phone Number 716 432 3117
Contact Email Address soaresjaime1924@gmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 31
Total Number of Identified Service Lines 31
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 31
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 31 0
Customer - Side Service Lines 0 0 GSL 31 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 31 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 31 0
Field Inspection 0 0
Customer Identification with Photo or other Verification NA 31
Excavation 0 0
Sequential Sampling 0 0
Statistical Analysis/Predictive Model 0 0

IV. Inventory Availability - The inventory must be available to public

If 50,000 customers or greater: Posting the inventory online water system's website. 11796 Sparks Rd Freedom NY 14065
If under 50,000 customers: Explain how to access the inventory

V. Certifications

By submitting this form, I have verified and certify the information listed in this form is true and accurate to the best of my knowledge and belief.

Gary Kepp
Name
Owner
Title
10/15/24
Date