Summary of Lead Service Line Inventory - Mosdos Satmar (NY5230217)

I. System Information

Water System Name Mosdos Satmar
PWS ID Number NY5230217

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

Contact Name James Barbehenn
Contact Phone Number 845-745-5011
Contact Email Address james.barbehenn@h2oinnovation.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 1
Total Number of Identified Service Lines 0
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 0
Total Number of Unknown Service Lines 1
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 1 0
Customer - Side Service Lines 0 0 GSL 0 1
Total Number of Service Lines in the Distribution System 0 0 GSLRR 0 1
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 1 0
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 Hard copy will be posted on communications board

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.

James Barbehenn
Name
Senior Project Manager
Title
11/18/24
Date