Summary of Lead Service Line Inventory - Village of Middleburgh (NY4700096)

I. System Information

Water System Name Village of Middleburgh
PWS ID Number NY4700096

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

Contact Name Cole Keyser
Contact Phone Number 518-469-5099
Contact Email Address dpwvom@midtel.net

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 564
Total Number of Identified Service Lines 179
Total Number of Lead Service Lines 0
Total Number of GSLRR 3
Total Number of Non-LSL 176
Total Number of Unknown Service Lines 385
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 177 387
Customer - Side Service Lines 0 6 GSL 228 330
Total Number of Service Lines in the Distribution System 0 3 GSLRR 176 385
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 46 32
Field Inspection 4 124
Customer Identification with Photo or other Verification NA 0
Excavation 127 78
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 Will be available in the Village Hall

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.

Cole Keyser
Name
Superintedent
Title
10/16/24
Date