Summary of Lead Service Line Inventory - Coxsackie Consolidated (NY1930072)

I. System Information

Water System Name Coxsackie Consolidated
PWS ID Number NY1930072

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

Contact Name Adelord (Al) Preville
Contact Phone Number 518-731-2626
Contact Email Address apreville@waterplantcoxsackie.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 139
Total Number of Identified Service Lines 16
Total Number of Lead Service Lines 3
Total Number of GSLRR 3
Total Number of Non-LSL 10
Total Number of Unknown Service Lines 123
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 3 0 GSL 16 147
Customer - Side Service Lines 0 3 GSL 55 81
Total Number of Service Lines in the Distribution System 3 3 GSLRR 10 123
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 72 19
Field Inspection 5 41
Customer Identification with Photo or other Verification NA 16
Excavation 0 0
Sequential Sampling 0 0
Statistical Analysis/Predictive Model 3 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 VillageofCoxsackie.com

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.

Adelord (Al) Preville
Name
V/O Coxsackie Water Dept. Superintendent
Title
10/07/24
Date