Summary of Lead Service Line Inventory - GRANGE ROAD MOBILE ESTATES (NY4501794)

I. System Information

Water System Name GRANGE ROAD MOBILE ESTATES
PWS ID Number NY4501794

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

Contact Name Pamela C. George, Authorized Agent
Contact Phone Number 518-250-4496
Contact Email Address pamgeorge@zapponelaw.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 25
Total Number of Identified Service Lines 25
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 25
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 2 GSL 23 0
Customer - Side Service Lines 0 0 GSL 25 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 25 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 25 25
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 Inventory Summary hand-delivered to each customer address within mobile home park.

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.

Pamela C. George
Name
Authorized Agent
Title
11/19/24
Date