| |
Location Information |
System-Owned Portion |
Customer-Owned Portion |
|
| |
Unique Service Line ID |
Street
Address |
Other
Locational Identifier |
System-Owned
Portion
Service Line Material Classification |
Lead Connector Present? |
If Material Anything Other than "Lead" in Column
E,
Was Material Ever Previously Lead? |
Service Line Installation Date |
Service Line Size (inches) |
Basis of Material Classification |
Was the Service Line Material Field Verified? |
Describe
the Field Verification Method |
Enter the
Date of Field Verification |
Notes |
Customer-Owned Portion
Service Line Material Classification |
Service
Line Installation Date |
Service Line Size (inches) |
Basis of Material Classification |
Was the Service Line Material Field Verified? |
Describe
the Field Verification Method |
Enter the
Date of Field Verification |
Notes |
Entire Service Line
Material Classification (if error or"Missing
Information" appears, ensure all required columns are filled correctly.
See instructions) |
| |
028-300-050-000 |
7500
ORO BANGOR HWY |
|
Non-Lead - Other |
No |
No |
1989 |
1.00 |
Installation
date is after state or local lead ban |
No |
|
|
|
Non-Lead - Other |
1989 |
|
Installation
date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-037-000 |
5716 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-047-000 |
5695 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-067-000 |
5673 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-240-027-000 |
5774 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-240-063-000 |
5768 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-012-000 |
5726 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-240-064-000 |
5728 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-210-017-000 |
5895 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-062-000 |
5690 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-073-000 |
5736 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-054-000 |
5717 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-034-000 |
5704 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-240-063-000 |
5768 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-240-061-000 |
5864 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-012-000 |
5726 LA PORTE RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-300-008-000 |
89 BANGOR PARK RD |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-300-055-000 |
74 KUMBAK LN |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-300-055-000 |
100 KUMBAK LN |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-300-027-000 |
7540 ORO BANGOR HWY |
Cal
Fire |
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-300-027-000 |
7540 ORO BANGOR HWY |
Bangor
Fill Station |
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-260-051-000 |
7594 ORO BANGOR HWY |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-240-005-000 |
7549 ORO BANGOR HWY |
|
Non-Lead
- Other |
No |
No |
1989 |
2.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
| |
028-300-047-000 |
7454 ORO BANGOR HWY |
|
Non-Lead
- Other |
No |
No |
1989 |
1.00 |
Installation date is after state or local lead ban |
No |
|
|
|
Non-Lead
- Other |
1989 |
|
Installation date is after state or local lead ban |
No |
|
|
|
Non-lead |
|
|
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