Summary of Lead Service Line Inventory - Coxsackie Correctional Facility (NY1902012)

I. System Information

Water System Name Coxsackie Correctional Facility
PWS ID Number NY1902012

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

Contact Name John Rice
Contact Phone Number 518-731-2781 ext 3980
Contact Email Address John.Rice2@doccs.ny.gov

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 37
Total Number of Identified Service Lines 37
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 37
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 37 0
Customer - Side Service Lines 0 0 GSL 37 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 37 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 37 37
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. 11260 Rt. 9w, Coxsackie, NY, 12051
If under 50,000 customers: Explain how to access the inventory DOCCS Property- Plant Superintendent's 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.

John Rice
Name
Senior Water Plant Operator
Title
09/12/24
Date