Summary of Lead Service Line Inventory - Pleasant View Mobile Home Park (NY5405826)

I. System Information

Water System Name Pleasant View Mobile Home Park
PWS ID Number NY5405826

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

Contact Name John Kaufmann
Contact Phone Number 9175756469
Contact Email Address jk1084@gmail.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 50
Total Number of Identified Service Lines 50
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 50
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 50 0
Customer - Side Service Lines 0 0 GSL 50 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 50 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 50 50
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 me

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.

John Kaufmann
Name
Member, Pleasant View Mobile Home Park, LLC
Title
05/21/24
Date