Summary of Lead Service Line Inventory - Village of Poland (NY2102313)

I. System Information

Water System Name Village of Poland
PWS ID Number NY2102313

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

Contact Name Scot Burritt
Contact Phone Number 315-826-3141
Contact Email Address watersuperintendent@villageofpolandny.org

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 178
Total Number of Identified Service Lines 151
Total Number of Lead Service Lines 0
Total Number of GSLRR 90
Total Number of Non-LSL 61
Total Number of Unknown Service Lines 27
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 3 GSL 144 31
Customer - Side Service Lines 0 92 GSL 68 18
Total Number of Service Lines in the Distribution System 0 90 GSLRR 61 27
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 174 79
Field Inspection 0 68
Customer Identification with Photo or other Verification NA 13
Excavation 2 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 Please contact the Village office at 315826-3141

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.

Scot Burritt
Name
Water treatment plant operator
Title
10/15/24
Date