Summary of Lead Service Line Inventory - Green Haven Correctional Facility (NY1300425)

I. System Information

Water System Name Green Haven Correctional Facility
PWS ID Number NY1300425

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

Contact Name David Scaturro/ Robert Rainbolt
Contact Phone Number (845) 221-2711Ext. 3965
Contact Email Address David.Scaturro@doccs.ny.gov

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 60
Total Number of Identified Service Lines 57
Total Number of Lead Service Lines 0
Total Number of GSLRR 2
Total Number of Non-LSL 55
Total Number of Unknown Service Lines 3
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 1 GSL 57 2
Customer - Side Service Lines 0 2 GSL 57 1
Total Number of Service Lines in the Distribution System 0 2 GSLRR 55 3
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 32 28
Field Inspection 22 27
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 Law Library, PS Office x3950

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.

Robert Rainbolt
Name
Senior Filter Plant Operator
Title
10/10/24
Date