Summary of Lead Service Line Inventory - Community @ Bells Pond (NY1006319)

I. System Information

Water System Name Community @ Bells Pond
PWS ID Number NY1006319

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

Contact Name James Alvarez
Contact Phone Number 518.821.0834
Contact Email Address jmalvarez9296@gmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 133
Total Number of Identified Service Lines 133
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 0
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 0 0
Customer - Side Service Lines 0 0 GSL 0 0
Total Number of Service Lines in the Distribution System 151 0 GSLRR 0 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
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: 3572 Route 9 Hudson, NY 12534
If under 50,000 customers: Explain how to access the inventory Inventory is posted for view. Customers may contact the park owner to also view/retain a copy.

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.

James Alvarez
Name
President
Title
09/27/24
Date