Summary of Lead Service Line Inventory - Darrow School - Wickersham (NY1002628)

I. System Information

Water System Name Darrow School - Wickersham
PWS ID Number NY1002628

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

Contact Name Thomas Seamon
Contact Phone Number 518-322-2457
Contact Email Address tomseamon@comcast.net

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 16
Total Number of Identified Service Lines 16
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 16
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 16 0
Customer - Side Service Lines 0 3 GSL 13 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 16 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 16
Field Inspection 0 0
Customer Identification with Photo or other Verification NA 0
Excavation 16 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 Posting the inventory online water system's website

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.

Thomas Seamon
Name

Title
02/05/25
Date