Summary of Lead Service Line Inventory - Omega Institute (NY1330037)

I. System Information

Water System Name Omega Institute
PWS ID Number NY1330037

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

Contact Name Robert Skip Backus
Contact Phone Number 845-266-4444 x375
Contact Email Address rcbackus@eomega.org

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 73
Total Number of Identified Service Lines 73
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 73
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 73 0
Customer - Side Service Lines 0 0 GSL 73 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 73 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 73 73
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 site inspection and archive documents at 150 Lake Drive, Rhinebeck

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.

_____________________________________
Name
CEO Emeritus
Title
02/07/24
Date