Summary of Lead Service Line Inventory - Wildwood Mobile Home (NY4800729)

I. System Information

Water System Name Wildwood Mobile Home
PWS ID Number NY4800729

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

Contact Name Richard Hoffman
Contact Phone Number 607-417-5703 x 101
Contact Email Address alpinerh@yahoo.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 14
Total Number of Identified Service Lines 14
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 14
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 14 0
Customer - Side Service Lines 0 0 GSL 14 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 14 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 14 14
Field Inspection 0 0
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 Can email at alpinerh@yahoo.com or dlh3960@yahoo.com

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.

Richard Hoffman
Name
Owner
Title
10/16/24
Date