Summary of Lead Service Line Inventory - ROBERT MOSES STATE PARK (NY5117671)

I. System Information

Water System Name ROBERT MOSES STATE PARK
PWS ID Number NY5117671

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

Contact Name Craig Milne
Contact Phone Number 631-669-0449
Contact Email Address

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 27
Total Number of Identified Service Lines 15
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 15
Total Number of Unknown Service Lines 12
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 18 10
Customer - Side Service Lines 0 0 GSL 15 12
Total Number of Service Lines in the Distribution System 0 0 GSLRR 15 12
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 17 17
Field Inspection 1 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

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.

CRAIG MILNE
Name
sanitation superintendent 10/26/2024
Title

Date