ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
2
3
LEAD SERVICE LINE INVENTORYMSSL TierCWSs NTNCWSs
4
Tier 1SFSs served by LSLs. Buildings w/ LSLs
5
As part of the revision, all water systems must develop an initial inventory of all service lines connected to the public water system.MFRs if they represent ≥20% of structures served
6
7
Tier 2Non-Residential Buildings and MFRs served by LSLs. N/A
8
System Information
9
Water System NameCrossville Water DepartmentTier 3SFSs with galvanized service lines downstream of an LSL, currently or in the past known to be downstream of a lead connector.SFSs with galvanized service lines downstream of an LSL, currently or in the past known to be downstream of a lead connector.
10
PWSID #TN0000150
11
Total connections #15,354
12
Contact Information
13
NameJoe KerleyTier 4SFSs with Cu pipes w/ Pb solder installed before July 1988, the effective date of the State’s Pb banN/A
14
TitleDirector
15
Phone931-267-1447
16
Emailjoe.kerley@crossvilletn.govTier 5Representative sample where the plumbing is similar to that used at other sites served. Representative sample where the plumbing is similar to that used at other sites served.
17
18
The following list of sources of information must be reviewed when competing the LSLI:
19
Distribution system maps and recorded drawingsAcronyms: 
20
Information collected for the presence of lead and copper as requiredCWS = community water system
21
under the Code of Federal Regulations (CFR) 40 CFR 141.42.NTNCWS = non-transient non-community water system
22
Capital improvement plans and/or master plans for distribution systemLSL = lead service line
23
developmentSFS = single family structure
24
Current and historical standard operating procedures and/or operationMFR = multi-family residence
25
and maintenance (O&M) manuals for the type of materials used forN/A = not applicable
26
service connections
27
Utility records including meter installation records, customer complaint
28
investigations, and all historical documentation which indicate and/or
29
 confirm the location of lead service connections
30
Existing water quality data for indications of “troubled areas”
31
Optional sources of information
32
Interviews with senior personnel
33
Conducted service line sampling where lead service lines are suspected to
34
exist but their presence is not confirmed
35
Review of permit files
36
Community survey
37
Review of USGS maps and records
38
Interviews with pipe suppliers, contractors, and/or developers
39
40
*All sites must have unique location idenitfier information.
41
Sites with Lead or Galvanized previously downstream of Lead may be added to the Master Sampling
42
Site List (MSSL) and may require additional information.
43
44
Submit completed form to: DWRwater.compliance@tn.gov
45
46
Select the Service Line Inventory tab to complete form
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100