Summary of Lead Service Line Inventory - Mazza Leone MHP (NY4301305)

I. System Information

Water System Name Mazza Leone MHP
PWS ID Number NY4301305

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

Contact Name Tim Fuller
Contact Phone Number 8.455445181E9
Contact Email Address timothyffuller@hotmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 37.0
Total Number of Identified Service Lines 37.0
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 37.0
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 0
Customer - Side Service Lines 0 0 GSL 36.0 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 37.0 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 1.0 1
Field Inspection 1.0 36.0
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 email, mail, by phone

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.

Timothy Fuller
Name
Operator
Title

Date