Summary of Lead Service Line Inventory - Jock's Mobile Estates (NY1613600)

I. System Information

Water System Name Jock's Mobile Estates
PWS ID Number NY1613600

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

Contact Name Robert E Jock
Contact Phone Number (518) 358-9567
Contact Email Address rjockny@aol.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 40
Total Number of Identified Service Lines 40
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 40
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 40 0
Customer - Side Service Lines 0 0 GSL 40 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 40 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 40 0
Field Inspection 0 40
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 Available at Office

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 E. Jock
Name
________________Owner__________________
Title
09/09/24
Date