Summary of Lead Service Line Inventory - Town of Goshen Consolidated Water District (NY3503605)

I. System Information

Water System Name Town of Goshen Consolidated Water District
PWS ID Number NY3503605

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

Contact Name Dominic Hillard
Contact Phone Number 845-428-1823
Contact Email Address dominic.hillard@h2oinnovation.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 262
Total Number of Identified Service Lines 1
Total Number of Lead Service Lines 0
Total Number of GSLRR 1
Total Number of Non-LSL 0
Total Number of Unknown Service Lines 261
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 0 262
Customer - Side Service Lines 0 1 GSL 256 5
Total Number of Service Lines in the Distribution System 0 1 GSLRR 0 261
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 0 258
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 www.townofgoshen.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.

Karina N. Wigger
Name
Clerk to the Supervisor
Title
10/16/24
Date