Summary of Lead Service Line Inventory - Town of Champion: Water District 1 and 3 (NY2230021)

I. System Information

Water System Name Town of Champion: Water District 1 and 3
PWS ID Number NY2230021

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

Contact Name Christina Vargulick
Contact Phone Number (315) 493-3240
Contact Email Address chris@racog.org

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 173
Total Number of Identified Service Lines 173
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 173
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 173 0
Customer - Side Service Lines 0 2 GSL 171 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 173 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 83 0
Field Inspection 90 89
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 https://champion.racog.org/

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.

Thomas E Stewart
Name
Town Supervisor
Title

Date