Summary of Lead Service Line Inventory - Moderne Barn (NY5930116)

I. System Information

Water System Name Moderne Barn
PWS ID Number NY5930116

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

Contact Name Bill Livanos
Contact Phone Number (914) 730-0001
Contact Email Address blivanos63@icloud.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 2
Total Number of Identified Service Lines 2
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 2
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 2 0
Customer - Side Service Lines 0 0 GSL 2 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 2 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 2 2
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 The lead service line inventory can be accessed by contacting Bill Livanos at (914) 730-0001

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.

Adam Smith
Name
Water Operator
Title
08/01/24
Date