Summary of Lead Service Line Inventory - Village of North Collins (NY1400517)

I. System Information

Water System Name Village of North Collins
PWS ID Number NY1400517

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

Contact Name Keith Ayers
Contact Phone Number 716-337-2407
Contact Email Address ncdpw@yahoo.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 500
Total Number of Identified Service Lines 250
Total Number of Lead Service Lines 10
Total Number of GSLRR 22
Total Number of Non-LSL 218
Total Number of Unknown Service Lines 250
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 572 0
Customer - Side Service Lines 10 22 GSL 220 264
Total Number of Service Lines in the Distribution System 10 22 GSLRR 218 250
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 500 0
Field Inspection 0 1
Customer Identification with Photo or other Verification NA 250
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 Village office: 10543 Main St, North Collins, NY 14111

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.

Keith Ayers
Name
Public Works Superintendent
Title

Date