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[null,"DEP_10-S_00027.1 ",null,null,null,"Annual Lead Service Line Replacement Progress Report"]
[null,"05/2022",null,null,null,"New Jersey Department of Environmental Protection"]
[null,null,null,null,null,"Division of Water Supply and Geoscience - Water System Operations Element"]
[null,null,null,null,null,null,null,null,"watersupply@dep.nj.gov"]
[null,null,null,null,null,null,"Forms must be submitted to the Water Supply Mailbox with a subject line that includes Water System Name, PWSID and Form Number."]
[]
[]
[null,"I. System Information",null,null,null,null,"II. Contact Information for Owner/ Licensed Operator of Record Completing the Form"]
[null,"Water System Name:",null,null,null,null,"Contact Name:"]
[null,"PWSID Number:",null,null,null,null,"Contact Title: "]
[null,"Accurate as of:",null,null,null,null,"Contact Phone: "]
[null,null,null,null,null,null,"Contact Email: "]
[null,null,null,null,null," "]
[null,"III. Inventory Information "]
[null,"Owner of Service Lines: "]
[null,null,null,null,null,null,null,null,null,null,null,null,"Selection","Number of sites"]
[]
[null,"I. Lead"]
[]
[null,"II. Galvanized"]
[]
[null,"III. Lead gooseneck, pigtail, or connector"]
[]
[null,"IV. Lead Status Unknown"]
[]
[null,"V. Non-lead"]
[]
[null,null,null,null,null,null,null,null,null,null,"Total # of SLs",null,null,{"$f":"(N18+N20+N22+N24+N26)","v":0}]
[]
[null,null,"# of LSLs replaced this year:",null,null,null,null,null,null,null,"# of known SLs before replacement activities "]
[]
[null,null,null,null,null,null,null,null,null,null,"# of known Unknowns before replacement"]
[]
[null,"# of LSLs replaced 07/22/2021-06/30/2022:",null,0,null,{"$f":"(D34/N34)","v":{"$error":"#DIV/0!"}},null,"Yes","No",null,"# of known LSLs ",null,null,{"$f":"(N18+N20+N22)","v":0}]
[null,"# of LSLs replaced 07/01/2022-06/30/2023:",null,0,null,{"$f":"(D35/N34)","v":{"$error":"#DIV/0!"}},"Partial replacements?"]
[null,"# of LSLs replaced 07/01/2023-06/30/2024:",null,0,null,{"$f":"(D36/N34)","v":{"$error":"#DIV/0!"}},"If yes, how many?",null,null,null,"# of LSLs to be replaced annually:",null,null,{"$f":"N34*0.1","v":0}]
[null,"# of LSLs replaced 07/01/2024-06/30/2025:",null,0,null,{"$f":"(D37/N34)","v":{"$error":"#DIV/0!"}},"Optional Question","Yes","No"]
[null,"# of LSLs replaced 07/01/2025-06/30/2026:",null,0,null,{"$f":"(D38/N34)","v":{"$error":"#DIV/0!"}},"Filter distribution program?",null,null,null,"# of Unknowns identified 07/22/2021-06/30/2022:",null,null,0]
[null,"# of LSLs replaced 07/01/2026-06/30/2027:",null,0,null,{"$f":"(D39/N34)","v":{"$error":"#DIV/0!"}},"If yes, how many distributed?",null,null,null,"# of Unknowns identified 07/01/2022-06/30/2023:",null,null,0]
[null,"# of LSLs replaced 07/01/2027-06/30/2028:",null,0,null,{"$f":"(D40/N34)","v":{"$error":"#DIV/0!"}},null,null,null,null,"# of Unknowns identified 07/01/2023-06/30/2024:",null,null,0]
[null,"# of LSLs replaced 07/01/2028-06/30/2029:",null,0,null,{"$f":"(D41/N34)","v":{"$error":"#DIV/0!"}},null,null,null,null,"# of Unknowns identified 07/01/2024-06/30/2025:",null,null,0]
[null,"# of LSLs replaced 07/01/2029-06/30/2030:",null,0,null,{"$f":"(D42/N34)","v":{"$error":"#DIV/0!"}},null,null,null,null,"# of Unknowns identified 07/01/2025-06/30/2026:",null,null,0]
[null,"# of LSLs replaced 07/01/2030-06/30/2031:",null,0,null,{"$f":"(D43/N34)","v":{"$error":"#DIV/0!"}},null,null,null,null,"# of Unknowns identified 07/01/2026-06/30/2027:",null,null,0]
[null,null,null,null,null,null,null,null,null,null,"# of Unknowns identified 07/01/2027-06/30/2028:",null,null,0]
[null,"Total # of service lines replaced: ",null,{"$f":"SUM(D34:D44)","v":0},null,{"$f":"SUM(F34:F43)","v":{"$error":"#DIV/0!"}},null,null,null,null,"# of Unknowns identified 07/01/2028-06/30/2029:",null,null,0]
[null,null,null,null,null,null,null,null,null,null,"# of Unknowns identified 07/01/2029-06/30/2030:",null,null,0]
[null,null,null,null,null,null,null,null,null,null,"# of Unknowns identified 07/01/2030-06/30/2031:",null,null,0]
[]
[null,null,null,null,null,null,null,null,null,null,"Total# of Unknowns identified: ",null,null,{"$f":"SUM(N38:N47)","v":0}]
[]
[]
[null,"IV. Certifications"]
[]
[null,"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."]
[]
[null,null,"Water System Owner or Licensed Operator Name",null,null,null,null,"Date",null,null,"Title (if WS Owner)"]
[]
[null,null,"Email",null,null,null,null,"Phone Number",null,null,"License Number (if LO)"]
[]
[]
[]
[null,"*This form must be submitted by the Water System Owner or its Licensed Operator of Record.*"]