Summary of Lead Service Line Inventory - Clifton Park Water Authority (NY4500175)

I. System Information

Water System Name Clifton Park Water Authority
PWS ID Number NY4500175

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

Contact Name Chris Wheland
Contact Phone Number 518-383-1122
Contact Email Address cwheland@cpwa.org

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 13806
Total Number of Identified Service Lines 9954
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 9954
Total Number of Unknown Service Lines 3852
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 9954 3852
Customer - Side Service Lines 0 0 GSL 9954 3852
Total Number of Service Lines in the Distribution System 0 0 GSLRR 9954 3852
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 5640 5641
Field Inspection 0 0
Customer Identification with Photo or other Verification NA 0
Excavation 104 104
Sequential Sampling 0 0
Statistical Analysis/Predictive Model 4210 4210

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: Not Applicable
If under 50,000 customers: Explain how to access the inventory Customers may contact CPWA directly for an electronic copy or stop by the main office.

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.

_____________________________________
Name
_____________________________________
Title

Date