Summary of Lead Service Line Inventory - Heritage Village Retirement Campus (NY0600820)

I. System Information

Water System Name Heritage Village Retirement Campus
PWS ID Number NY0600820

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

Contact Name Perry Glenn Williams
Contact Phone Number 716-985-6834
Contact Email Address pwilliams@heritage1886.org

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 28
Total Number of Identified Service Lines 28
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 28
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 28 0
Customer - Side Service Lines 0 0 GSL 28 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 28 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 28 19
Customer Identification with Photo or other Verification NA 9
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. Address:
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.

Perry Glenn Williams
Name
Director of Environmental Servcies Senior Water Operator 10/16/2024
Title

Date