Summary of Lead Service Line Inventory - Van Etten Water District (NY0730033)

I. System Information

Water System Name Van Etten Water District
PWS ID Number NY0730033

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

Contact Name Harold Shoemaker
Contact Phone Number 607-589-4435 ext 8
Contact Email Address haroldshoe@yahoo.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 204
Total Number of Identified Service Lines 204
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 204
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 204 0
Customer - Side Service Lines 0 0 GSL 204 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 204 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 204 204
Field Inspection 0 0
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 Note on bill and at Town Hall lead inventory available at Town Hall.

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.

____Donna Redsicker___________________
Name
___Water Clerk__________________________
Title

Date