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Click ‘Get Form’ to open the MO 780-0804 form in the editor.
Begin by entering your Customer Number and Customer Name at the top of the form. This information is essential for identifying your report.
Fill in the Mailing Address and Service Location fields accurately to ensure proper communication regarding your backflow prevention assembly test.
Input the Meter Number, Date of Test, and Time (A.M. or P.M.) in their respective fields. This data is crucial for record-keeping.
Complete the Manufacturer and Type of Assembly sections, including height off floor and supply pressure details. Ensure all measurements are precise.
Indicate whether protection from freezing and flooding is required by selecting 'Yes' or 'No'.
Document the results of both initial and final tests after repair, including any comments regarding performance or issues encountered.
Finally, ensure that all signatures are collected from testers and owners before submitting the completed form.

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