Summary of Lead Service Line Inventory - Hornellsville WD4 (NY5030112)

I. System Information

Water System Name Hornellsville WD4
PWS ID Number NY5030112

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

Contact Name Joseph Demick
Contact Phone Number 5856105707
Contact Email Address arkport.dpw@gmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 17
Total Number of Identified Service Lines 17
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 17
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 17 0
Customer - Side Service Lines 0 1 GSL 16 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 17 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 15 2
Field Inspection 0 8
Customer Identification with Photo or other Verification NA 4
Excavation 2 0
Sequential Sampling 0 0
Statistical Analysis/Predictive Model 0 3

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 The inventory will be avaliable in paper form at the village clerks office.

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.

Joseph Demick
Name
water operator
Title
10/15/24
Date