Summary of Lead Service Line Inventory - Town of Jefferson (NY4700095)

I. System Information

Water System Name Town of Jefferson
PWS ID Number NY4700095

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

Contact Name Aaron House
Contact Phone Number 607-434-0414
Contact Email Address ahouse80@hotmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 94
Total Number of Identified Service Lines 69
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 69
Total Number of Unknown Service Lines 25
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 94 0
Customer - Side Service Lines 0 0 GSL 69 25
Total Number of Service Lines in the Distribution System 0 0 GSLRR 69 25
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 94 0
Field Inspection 0 94
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 Available at Town Clerks Office and posted with Annual Water Quality Report

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.

Aaron House
Name
Operator
Title

Date