Summary of Lead Service Line Inventory - Country Acres Park (NY5405805)

I. System Information

Water System Name Country Acres Park
PWS ID Number NY5405805

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

Contact Name Philip Migliore
Contact Phone Number 845-343-7966
Contact Email Address vistagroup626@gmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 102
Total Number of Identified Service Lines 91
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 91
Total Number of Unknown Service Lines 11
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 102 0
Customer - Side Service Lines 0 0 GSL 91 11
Total Number of Service Lines in the Distribution System 0 0 GSLRR 91 11
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 102 11
Field Inspection 0 91
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 Contact Main Office at 845-343-7966 to access full inventory. Notice Posted on Site

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.

Philip Migliore
Name
Manager
Title
09/18/24
Date