Summary of Lead Service Line Inventory - Ametek Rotron (NY5510733)

I. System Information

Water System Name Ametek Rotron
PWS ID Number NY5510733

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

Contact Name George W. Burns
Contact Phone Number 845-679-1336
Contact Email Address george.burns@ametek.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 2
Total Number of Identified Service Lines 1
Total Number of Lead Service Lines 0
Total Number of GSLRR 1
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 0 2
Customer - Side Service Lines 0 1 GSL 1 0
Total Number of Service Lines in the Distribution System 0 1 GSLRR 0 1
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 2 2
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 No customers, private manufacturing facility.

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.

George W. Burns
Name
Environmental technician
Title
11/12/24
Date