PBCU Sample Site ID (e.g. PBCU01) (Optional)

Street Address

Lot (Optional)

Block (Optional)

Easting (X) (Optional)

Northing (Y) (Optional)

Latitude (Optional)

Longitude (Optional)

Locational Identifier (Optional)

Service Line Category

Suspected to be lead? (Y/N) (Complete if answered UL for column L)

Public Service Line Materials

Public Service Line - Other Materials (Provide only if Column N is indicated as O)

Customer Service Line Materials

Customer Service Line - Other Materials (Only provide if Column P is indicated as O)

PWS Service Line Install Date (Optional)

Customer Service Line Install Date (optional)

Service Line Length (ft.) (Optional)

PCWS Service Line - Verification Source

PCWS Service Line - Other Source (Provide only if Column U is indicated as O)

PCWS Service Line - Reasoning

PCWS Service Line - Steps to be Taken to ID

Customer Service Line - Verification Source

Customer Service Line - Other Source (Provide only if Column Y is indicated as O)

Customer Service Line- Reasoning

Customer Service Line - Steps to be Taken to ID

Attachments (Y/N) (Optional)

PCWS Service Line Diameter (Optional)2

Customer Service Line Diameter (optional)

Building Type (Optional)

DEP Comments

40 RIVERSIDE DR

Only Customer side believed to be copper

Suspected galvanized observed during water inspection

Plumbing inspection - 2022 - we have notified homeowner that we believe there to be a galvanized line. We will next begin an excavation of the service line surrounding the curb box

42 RIVERSIDE DR

Only Customer side believed to be copper

Suspected galvanized observed during water inspection

250 RIDGEDALE AVE

Other non-residential

250 RIDGEDALE AVE

Other non-residential

250 RIDGEDALE AVE

Other non-residential

250 RIDGEDALE AVE

Other non-residential

250 RIDGEDALE AVE A-7

250 RIDGEDALE AVE B-1

250 RIDGEDALE AVE B-4

250 RIDGEDALE AVE B-5

250 RIDGEDALE AVE B-7

250 RIDGEDALE AVE B-8

250 RIDGEDALE AVE C-1

250 RIDGEDALE AVE C-2

250 RIDGEDALE AVE C-4

250 RIDGEDALE AVE C-8

250 RIDGEDALE AVE D-2

250 RIDGEDALE AVE D-3

250 RIDGEDALE AVE D-4

250 RIDGEDALE AVE D-5

250 RIDGEDALE AVE D-6

250 RIDGEDALE AVE D-7

250 RIDGEDALE AVE E-1

250 RIDGEDALE AVE E-2

250 RIDGEDALE AVE E-3

250 RIDGEDALE AVE E-4

250 RIDGEDALE AVE E-5

250 RIDGEDALE AVE E-6

250 RIDGEDALE AVE E-7

250 RIDGEDALE AVE E-8

250 RIDGEDALE AVE F-1

250 RIDGEDALE AVE F-2

250 RIDGEDALE AVE F-3

250 RIDGEDALE AVE F-4

250 RIDGEDALE AVE F-5

250 RIDGEDALE AVE F-6

250 RIDGEDALE AVE H-7

250 RIDGEDALE AVE I-7

250 RIDGEDALE AVE K-6

250 RIDGEDALE AVE L-3

250 RIDGEDALE AVE M-4

250 RIDGEDALE AVE P-1

250 RIDGEDALE AVE P-7

250 RIDGEDALE AVE R-4

250 RIDGEDALE AVE U-3

250 RIDGEDALE AVE X-7

83 HANOVER RD

Other non-residential

83 HANOVER RD

Other non-residential

38 PARK ST.1-A

38 PARK ST.1-D

38 PARK ST.1-E

38 PARK ST.1-F

38 PARK ST.1-G

38 PARK ST.3-B

38 PARK ST.3-C

38 PARK ST.3-D

38 PARK ST.3-E

38 PARK ST.3-F

38 PARK ST.3-G

38 PARK ST.3-H

38 PARK ST.4-A

38 PARK ST.4-B

38 PARK ST.4-C

38 PARK ST.4-D

38 PARK ST.4-E

38 PARK ST.4-F

38 PARK ST.4-G

38 PARK ST.4-H

38 PARK ST.5-A

38 PARK ST.5-B

38 PARK ST.5-C

38 PARK ST.5-D

38 PARK ST.5-E

38 PARK ST.5-F

38 PARK ST.5-G

38 PARK ST.6-A

38 PARK ST.6-B

38 PARK ST.6-C

38 PARK ST.6-D

38 PARK ST.6-E

38 PARK ST.6-F

38 PARK ST.7-A

38 PARK ST.7-B

38 PARK ST.7-C

38 PARK ST.7-D

38 PARK ST.7-E

38 PARK ST.7-F

38 PARK ST.7-G

38 PARK ST.7-H

38 PARK ST.8-A

38 PARK ST.8-B

38 PARK ST.8-C

38 PARK ST.8-D

38 PARK ST.8-E

38 PARK ST.8-F

38 PARK ST.8-G

38 PARK ST.8-H