Summary of Lead Service Line Inventory - Lake Lucille Property Owners Association (NY4303660)

I. System Information

Water System Name Lake Lucille Property Owners Association
PWS ID Number NY4303660

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

Contact Name Jayashree Bhattacharyya
Contact Phone Number 845-634-0881
Contact Email Address jaya902@gmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 35
Total Number of Identified Service Lines 35
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 35
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 7 GSL 28 0
Customer - Side Service Lines 0 7 GSL 28 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 35 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 9 10
Field Inspection 11 11
Customer Identification with Photo or other Verification NA 14
Excavation 4 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 Website: lakelucille.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.

Jayashree Bhattacharyya
Name
Systems Operator
Title

Date