Summary of Lead Service Line Inventory - Varick #1 (NY4910643)

I. System Information

Water System Name Varick #1
PWS ID Number NY4910643

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

Contact Name Benjamin Karlsen
Contact Phone Number 315-719-7844
Contact Email Address Varickwater@yahoo.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 62
Total Number of Identified Service Lines 58
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 58
Total Number of Unknown Service Lines 4
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 62 0
Customer - Side Service Lines 0 0 GSL 58 4
Total Number of Service Lines in the Distribution System 0 0 GSLRR 58 4
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 62 57
Field Inspection 0 1
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 4782 RT 96 Romulus NY 14541

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.

Benjamin Karlsen
Name
_____________________________________
Title
10/16/24
Date