Summary of Lead Service Line Inventory - Village of Palatine Bridge (NY2800142)

I. System Information

Water System Name Village of Palatine Bridge
PWS ID Number NY2800142

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

Contact Name Rodney Sutton
Contact Phone Number 518-791-8079
Contact Email Address rodneysutton88@yahoo.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 304
Total Number of Identified Service Lines 304
Total Number of Lead Service Lines 1
Total Number of GSLRR 0
Total Number of Non-LSL 303
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 81 GSL 226 0
Customer - Side Service Lines 1 59 GSL 244 0
Total Number of Service Lines in the Distribution System 1 0 GSLRR 303 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 159 4
Field Inspection 126 267
Customer Identification with Photo or other Verification NA 16
Excavation 22 17
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: www.villageofpalatinebridge.org
If under 50,000 customers: Explain how to access the inventory

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.

____________Rodney Sutton_________________________
Name
__________________Operator___________________
Title

Date