Summary of Lead Service Line Inventory - Saratoga Glen Hollow Water Supply (NY4530032)

I. System Information

Water System Name Saratoga Glen Hollow Water Supply
PWS ID Number NY4530032

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

Contact Name Jake Fort
Contact Phone Number (518) 538-1480
Contact Email Address jcfwater@gmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 505
Total Number of Identified Service Lines 505
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 505
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 505 0
Customer - Side Service Lines 0 1 GSL 504 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 505 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 491 12
Field Inspection 3 479
Customer Identification with Photo or other Verification NA 0
Excavation 11 11
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 can be found on the web at https://health.data.ny.gov.

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.

Jacob Fort
Name
Chief Water Operator
Title

Date