Summary of Lead Service Line Inventory - Crosswinds (NY0622360)

I. System Information

Water System Name Crosswinds
PWS ID Number NY0622360

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

Contact Name Roger L Klossner II
Contact Phone Number 716-397-4758
Contact Email Address kkare@roadrunner.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 40
Total Number of Identified Service Lines 2
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 2
Total Number of Unknown Service Lines 38
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 2 38
Customer - Side Service Lines 0 0 GSL 40 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 2 38
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 40 40
Customer Identification with Photo or other Verification NA 0
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 Contact Rroger L Klossner II

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.

Roger L Klossner II
Name
President - Owner -Water Operator
Title
10/13/24
Date