Summary of Lead Service Line Inventory - LSLI_Hillview Terrace Mobile Home Park (NY5405814)

I. System Information

Water System Name LSLI_Hillview Terrace Mobile Home Park
PWS ID Number NY5405814

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

Contact Name Michael Silber (owner)
Contact Phone Number 607-249-6279
Contact Email Address kmp@silberrealestatemgt.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 59
Total Number of Identified Service Lines 59
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 59
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 34 GSL 25 0
Customer - Side Service Lines 0 31 GSL 28 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 59 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 59 59
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: 36 Chemung Street, Waverly NY
If under 50,000 customers: Explain how to access the inventory posted in the main 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.

_____Michael Silber__________________
Name
_______________Owner_____________
Title

Date