Summary of Lead Service Line Inventory - Averill Park Schools West Sand Lake (NY4117253)

I. System Information

Water System Name Averill Park Schools West Sand Lake
PWS ID Number NY4117253

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

Contact Name William Sansone
Contact Phone Number 518-674-7058
Contact Email Address sansoneb@apcsd.org

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 1
Total Number of Identified Service Lines 1
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 1
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 1 0
Customer - Side Service Lines 0 0 GSL 1 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 1 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 1 1
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 Call the main office 518-674-7058

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.

William Sansone
Name
Assistant Director of Facilites
Title
11/19/24
Date