Summary of Lead Service Line Inventory - Polo Fields Water District (NY1330557)

I. System Information

Water System Name Polo Fields Water District
PWS ID Number NY1330557

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

Contact Name Edward Balicki
Contact Phone Number 845-831-3136
Contact Email Address ebalicki@beaconny.gov

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 97
Total Number of Identified Service Lines 97
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 97
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 97 0
Customer - Side Service Lines 0 0 GSL 97 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 97 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 97 97
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:
If under 50,000 customers: Explain how to access the inventory LSI map is a available on https://beaconny.gov/

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.

Edward Balicki
Name
Superintendent of Water and Sewer
Title
11/25/24
Date