Summary of Lead Service Line Inventory - Dover Greens (NY1316987)

I. System Information

Water System Name Dover Greens
PWS ID Number NY1316987

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

Contact Name Marian Ribiero
Contact Phone Number
Contact Email Address 73 Wheeler Road, Dover NY

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 10
Total Number of Identified Service Lines 1
Total Number of Lead Service Lines 0
Total Number of GSLRR 1
Total Number of Non-LSL 0
Total Number of Unknown Service Lines 9
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 0 10
Customer - Side Service Lines 0 1 GSL 9 0
Total Number of Service Lines in the Distribution System 0 1 GSLRR 0 9
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 10
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 Inventory sent to ownership

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.

Cody Barticciotto
Name
Operator
Title
10/04/24
Date