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For detailed instructions CLICK HERE!
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PWS Name: Roseville PWS
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PWS ID:OH6002112
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Purpose of this worksheet: To provide a customizable format water systems can use to track materials for each service line in their distribution system.

General Instructions: Each row in this worksheet represents one service line connecting the water main to the customer's plumbing. The worksheet includes required and recommended elements; the columns with the RED shading are required by the LCRR and/or Ohio EPA. The BLUE columns are recommended. Informational notes for columns are in Row 12; Worksheet examples are included in rows 14 &15. This template is formatted for approximately 10,000 rows. The +/- button in the lefthand margin can be used to hide and unhide the PWS Information Box.
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Location InformationSystem-Owned PortionCustomer-Owned PortionOther Potential Sources of LeadAdditional Information to Assign Tap Monitoring TieringLead Service Line Replacement (LSLR)Comments
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Unique Service Line IDSite NameStreet NumberStreet NameCityZip CodeCountyLatitudeLongitudeIn Asset ManagementAsset StatusAsset Start DateAsset End DateSystem-Owned Portion
Service Line Material Classification
If Non-Lead in Column O…Is the Service Line MeteredService Line UseService Line SizeService Line LengthBasis of Material ClassificationWas the Service Line Material Field Verified?If Yes in Column W…Customer-Owned Portion
Service Line Material Classification
Service Line Installation DateService Line SizeService Line LengthBasis of Material ClassificationWas the Service Line Material Field Verified?If Yes in Column AE…Connector Material TypeIs there Lead Solder in the Service Line?Building Type Connected to Service LineIf Column AJ includes a school...Building Construction DateBuilding Plumbing MaterialsPlumbing installation/replacement date Point-of-Entry or Point-of-Use Treatment Present?LCR Sampling Point IDDate of System-owned LSLRDate of Customer-owned LSLR
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Was Material Ever Previously Lead?Service Line Installation DateDescribe the Field Verification MethodEnter the Date of Field VerificationDescribe the Field Verification MethodEnter the Date of Field VerificationLowest Grade Served
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A Unique ID by the public water system for each service line.Water systems must track addresses of all service lines in their internal inventory. For the publicly accessible version, location identifiers are required for lead and galvanized requiring replacement. If the system does not use addresses for their location identifier, other options could include GPS coordinates, landmark, intersection, block, or other details to specify service line locations.If "Non-Lead Other", describe in Comments fieldImportant for determining if service line requires replacementEstimated date when the service line was installed or replacedService Line Metered or Not MetteredDrinking, Non-Drinking, CombinationDiameter in inchesLength in FeetSelect option from drop down list. If "Other," describe in the Notes fieldIf Other, describe in the Notes fieldEstimated date of field verification or date that the record was updatedIf "Non-Lead Other", describe in Comments fieldEstimated date when the service line was installed or replacedDiameter in inchesLength in FeetIf Other, describe in the Notes fieldIf Other, describe in the Notes fieldEstimated date of field verification or date that the record was updatedFor example, lead gooseneck or pigtail where the water main is connected to the service lineThis information may be helpful for identifying lead tap monitoring locations.Please use this section to record any comments or notes associated with a service line.
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Example 1 (DO NOT DELETE)Site Name1234Test St.Test City88888Test County##.#####-##.#####Yes, No, UnknownActive, Inactive, Not Applicablemm/dd/yyyymm/dd/yyyyNon-Lead - CopperYes3/19/1999YesDrinking1.506Field inspection only with no recordsNoLead7/4/19051.256Previous materials evaluationYesVisual inspection at the meter pit5/1/2019LeadNoSingle Family Structure6/1/1968Galvanized6/1/1968YesLC201
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Example 2 (DO NOT DELETE)House 11502Main StBraceville44444Adams41.2566-80.9806NoActive1/1/20221/1/2023Non-Lead - PlasticNo4/2/2005YesDrinking1.256Previous Materials EvaluationYesVisual inspection at meter pit5/2/2019Non-Lead - Copper7/12/199129Water sampling only with no recordsNoNever LeadNo Single Family Structure with Childcare Facility2/16/2019Copper with Lead SolderYes
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Example 3 (DO NOT DELETE)Business 11268Main StBraceville44444Adams41.2560-80.9820YesInactive1/15/2016Non-Lead - CopperNoYesCombination2.508Installation record (e.g., tap card)NoNon-Lead - Plastic10/1/20012.0012Installation record (e.g., tap card)YesCustomer self-identification7/2/2017Never LeadNo Non-Residential Building10/1/2001Non-Lead- Plastic7/15/2015No
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0900900300007327 CERAMIC RD7327CERAMIC RDRoseville43777Perry39.7908-82.0842Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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0900012700007440 CERAMIC RD7440CERAMIC RDRoseville43777Perry39.7918-82.0838Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090001160000-17445 CERAMIC RD7445CERAMIC RDRoseville43777Perry39.7915-82.0842Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pitNon-Lead - Plastic
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090001160000-27465 CERAMIC RD7465CERAMIC RDRoseville43777Perry39.7919-82.0842Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090000560000-37507 CERAMIC RD7507CERAMIC RDRoseville43777Perry39.7928-82.0841Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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0900011200007559 CERAMIC RD7559CERAMIC RDRoseville43777Perry39.7934-82.0840Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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0900014900007560 CERAMIC RD7560CERAMIC RDRoseville43777Perry39.7935-82.0837Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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0900002800007587 CERAMIC RD7587CERAMIC RDRoseville43777Perry39.7937-82.0840Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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0900010200007616 CERAMIC RD7616CERAMIC RDRoseville43777Perry39.7938-82.0836Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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0900012500007560 CERAMIC RD7560CERAMIC RDRoseville43777Perry39.7938-82.0836Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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0900001100007621 CERAMIC RD7621CERAMIC RDRoseville43777Perry39.79441-82.08392Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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0900015800007674 CERAMIC RD7674CERAMIC RDRoseville43777Perry39.7952-82.08329Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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0900006900007677 CERAMIC RD7677CERAMIC RDRoseville43777Perry39.79519-82.08385Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090001470000-17711 CERAMIC RD7711CERAMIC RDRoseville43777Perry39.79549-82.08382Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090001470000-27725 CERAMIC RD7725CERAMIC RDRoseville43777Perry39.7957-82.0838Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090001470000-37737 CERAMIC RD7737CERAMIC RDRoseville43777Perry39.79595-82.08376Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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0900003400007771 CERAMIC RD7771CERAMIC RDRoseville43777Perry39.79611-82.08374Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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0900015300007758 CERAMIC RD7758CERAMIC RDRoseville43777Perry39.79627-82.08335Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000240000-17809 CERAMIC RD7809CERAMIC RDRoseville43777Perry39.79688-82.08356Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090000240000-27853 CERAMIC RD7853CERAMIC RDRoseville43777Perry39.79729-82.08343Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090002410000210 CROWLEY DR210CROWLEY DRRoseville43777Perry39.79955-82.07465Non-Lead - CopperNoDrinking WaterNoNon-Lead - Copper
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090002440000218 CROWLEY DR218CROWLEY DRRoseville43777Perry39.79958-82.07523Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000071000012398 OLD RAINER RD12398OLD RAINER RDRoseville43777Perry39.80098-82.08963Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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09000094000012422 OLD RAINER RD12422OLD RAINER RDRoseville43777Perry39.80096-82.08928Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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09000162000012436 OLD RAINER RD12436OLD RAINER RDRoseville43777Perry39.80161-82.08881Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000017190012380 OLD RAINER RD12380OLD RAINER RDRoseville43777Perry39.80358-82.08978Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000017110012490 OLD RAINER RD12490OLD RAINER RDRoseville43777Perry39.80202-82.08826Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000017040012350 OLD RAINER RD12350OLD RAINER RDRoseville43777Perry39.80499-82.09039Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000017030012370 OLD RAINER RD12370OLD RAINER RDRoseville43777Perry39.80399-82.08817Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000264000011976 OLD RAINER RD11976OLD RAINER RDRoseville43777Perry39.80197-82.09028Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000017110012360 OLD RAINER RD12360OLD RAINER RDRoseville43777Perry39.80204-82.08994Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000054000012494 OLD RAINER RD12494OLD RAINER RDRoseville43777Perry39.80091-82.08813Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000017170012500 OLD RAINER RD12500OLD RAINER RDRoseville43777Perry39.8009-82.08781Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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100004580000100 1/2 OLD RAINER RD100.5OLD RAINER RDRoseville43777Perry39.80055-82.08636Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100001690000101 OLD RAINER RD101OLD RAINER RDRoseville43777Perry39.8008-82.08603Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100004580000100 OLD RAINER RD100OLD RAINER RDRoseville43777Perry39.80053-82.08601Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100005420000-197 OLD RAINER RD97OLD RAINER RDRoseville43777Perry39.80077-82.08563Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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10000542000097 1/2 OLD RAINER RD97.5OLD RAINER RDRoseville43777Perry39.80076-82.08547Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100000970000-193 OLD RAINER RD93OLD RAINER RDRoseville43777Perry39.80074-82.08502Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100000970000-291 OLD RAINER RD91OLD RAINER RDRoseville43777Perry39.80074-82.08498Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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10000319000092 OLD RAINER RD92OLD RAINER RDRoseville43777Perry39.80046-82.08486Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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10000094000087 OLD RAINER RD87OLD RAINER RDRoseville43777Perry39.8007-82.0844Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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09000055000084 OLD RAINER RD84OLD RAINER RDRoseville43777Perry39.80043-82.08419Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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10000054000085 OLD RAINER RD85OLD RAINER RDRoseville43777Perry39.80069-82.08414Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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10000102000081 OLD RAINER RD81OLD RAINER RDRoseville43777Perry39.80069-82.08395Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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10000111000078 OLD RAINER RD78OLD RAINER RDRoseville43777Perry39.80041-82.08383Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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10000082000072 OLD RAINER RD72OLD RAINER RDRoseville43777Perry39.80064-82.0829Non-Lead - CopperYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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10000379010069 OLD RAINER RD69OLD RAINER RDRoseville43777Perry39.80036-82.08266Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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10000079000068 OLD RAINER RD68OLD RAINER RDRoseville43777Perry39.80062-82.08249Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100001050000-165 OLD RAINER RD65OLD RAINER RDRoseville43777Perry39.80034-82.08218Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100001050000-261 OLD RAINER RD61OLD RAINER RDRoseville43777Perry39.80034-82.08208Non-Lead - CopperYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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090000170600-112534 OLD RAINER RD 112534 OLD RAINER RD 1Roseville43777Perry39.80094-82.08688Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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090000170600-212534 OLD RAINER RD 212534 OLD RAINER RD 2Roseville43777Perry39.80104-82.08688Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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090000170600-312534 OLD RAINER RD 2212534 OLD RAINER RD 22Roseville43777Perry39.80108-82.08707Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-412534 OLD RAINER RD 312534 OLD RAINER RD 3Roseville43777Perry39.80116-82.08688Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-512534 OLD RAINER RD 2412534 OLD RAINER RD 24Roseville43777Perry39.8013-82.08706Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-612534 OLD RAINER RD 512534 OLD RAINER RD 5Roseville43777Perry39.80138-82.08687Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-712534 OLD RAINER RD 2512534 OLD RAINER RD 25Roseville43777Perry39.80141-82.08706Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-812534 OLD RAINER RD 612534 OLD RAINER RD 6Roseville43777Perry39.80149-82.08687Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-912534 OLD RAINER RD 812534 OLD RAINER RD 8Roseville43777Perry39.80171-82.08686Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-1012534 OLD RAINER RD 2812534 OLD RAINER RD 28Roseville43777Perry39.80174-82.08705Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-1112534 OLD RAINER RD 912534 OLD RAINER RD 9Roseville43777Perry39.80183-82.08686Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-1212534 OLD RAINER RD 3012534 OLD RAINER RD 30Roseville43777Perry39.80196-82.08704Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-1312534 OLD RAINER RD 1112534 OLD RAINER RD 11Roseville43777Perry39.80203-82.08685Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-1412534 OLD RAINER RD 1212534 OLD RAINER RD 12Roseville43777Perry39.80214-82.08685Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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090000170600-1512534 OLD RAINER RD 3212534 OLD RAINER RD 32Roseville43777Perry39.80217-82.08704Non-Lead - PlasticNoDrinking WaterNoNon-Lead - Plastic
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0900000100007868 WATT HILL RD NE7868WATT HILL RD NERoseville43777Perry39.79807-82.08665Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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09000052000012605 HARRISON TWP RD 166 NE12605HARRISON TWP RD 166 NERoseville43777Perry39.80164-82.08524Non-Lead - CopperYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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09000052010012635 HARRISON TWP RD 166 NE12635HARRISON TWP RD 166 NERoseville43777Perry39.80194-82.08508Non-Lead - CopperYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100005390000275 W ATHENS RD275W ATHENS RDRoseville43777Perry39.7993-82.08141Non-Lead - PlasticYes1/1/2000Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100002420000295 W ATHENS RD295W ATHENS RDRoseville43777Perry39.79894-82.08179Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100003840000265 W ATHENS RD265W ATHENS RDRoseville43777Perry39.79976-82.08152Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100005210000245 W ATHENS RD245W ATHENS RDRoseville43777Perry39.80016-82.08028Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100004170000264 W ATHENS RD264W ATHENS RDRoseville43777Perry39.80042-82.08033Non-Lead - CopperNoDrinking WaterNoNon-Lead - Copper
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100003820000242 W ATHENS RD242W ATHENS RDRoseville43777Perry39.80043-82.0799Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100005210100245 W ATHENS RD245W ATHENS RDRoseville43777Perry39.80025-82.07983Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100004160000229 W ATHENS RD229W ATHENS RDRoseville43777Perry39.80006-82.07955Non-Lead - CopperNoDrinking WaterNoNon-Lead - Plastic
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100003670000234 W ATHENS RD234W ATHENS RDRoseville43777Perry39.80042-82.07961Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100004160000221 W ATHENS RD221W ATHENS RDRoseville43777Perry39.80023-82.0794Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100002490000224 W ATHENS RD224W ATHENS RDRoseville43777Perry39.80041-82.07936Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100000470000219 W ATHENS RD219W ATHENS RDRoseville43777Perry39.80021-82.07902Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100003020000206 W ATHENS RD206W ATHENS RDRoseville43777Perry39.80038-82.07883Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100003110000205 W ATHENS RD205W ATHENS RDRoseville43777Perry39.8002-82.07879Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100000010000200 W ATHENS RD200W ATHENS RDRoseville43777Perry39.80037-82.07863Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic
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100003110000195 W ATHENS RD195W ATHENS RDRoseville43777Perry39.80019-82.07857Non-Lead - CopperYes1/1/1980Drinking WaterYesVisual inspection at the meter pit7/1/2023Non-Lead - Plastic