Summary of Lead Service Line Inventory - Village of Nassau (NY4100042)

I. System Information

Water System Name Village of Nassau
PWS ID Number NY4100042

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

Contact Name Peter Derkowski
Contact Phone Number 518-766-3044 Ext 0
Contact Email Address clerk@villageofnassau.org

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 408
Total Number of Identified Service Lines 408
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 408
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 408 0
Customer - Side Service Lines 0 13 GSL 395 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 408 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 406 0
Field Inspection 2 15
Customer Identification with Photo or other Verification NA 393
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. www.villageofnassau.org
If under 50,000 customers: Explain how to access the inventory www.villageofnassau.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.

Peter Derkowski
Name
Operator
Title
11/18/24
Date