Summary of Lead Service Line Inventory - Beaver Hollow conference Center/ Aquatics Center (NY6012849)

I. System Information

Water System Name Beaver Hollow conference Center/ Aquatics Center
PWS ID Number NY6012849

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

Contact Name Justin Reis
Contact Phone Number 5854573700
Contact Email Address jreis@beaverhollow.com

III. Summary of Inventory

Total Number of Service Lines in the Distribution System 26
Total Number of Identified Service Lines 26
Total Number of Lead Service Lines 0
Total Number of GSLRR 0
Total Number of Non-LSL 26
Total Number of Unknown Service Lines 0
Service Lines Lead GSL or GSLRR Non-Lead Unknown
PWS - Side Service Lines 0 0 GSL 26 0
Customer - Side Service Lines 0 0 GSL 26 0
Total Number of Service Lines in the Distribution System 0 0 GSLRR 26 0
Service Line Identification Methods
Identification Methods PWS- Side SLs Customer-Side SLs
Historical Records 0 0
Field Inspection 26 26
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 The Beaver Hollow Conference Center office at 585-457-9700

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.

Justin Reis
Name
Maintenance Manager
Title

Date