
ICATION (PWS) PWS NAME: PUBLIC WATER SYSTEM ID NUMBER: MO COUNTY PUBLIC WATER SYSTEM WEBSITE DATES AND CERTIFICATION A – Activated SERVICE CONNECTIONS (mm/dd/yyyy) SERVICE CONNECTIONS TYPE: D – Deactivated (mm/dd/yyyy) NUMBER OF SERVICE CONNECTIONS: SEASON BEGIN/END: (mm/dd)-(mm/dd) <1”: DATE SYSTEM BEGAN: (mm/dd/yyyy) POPULATION OPERATING PERMIT: (mm/dd/yyyy) RETAIL POPULATION SERVED: TREATMENT CERTIFICATION LEVEL: OTHER GOVERNMENT AGENCY (if applicable): DISTRIBUTION CE.
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How to fill out the MO MO 780-1231 online
Filling out the MO MO 780-1231 form can be a straightforward process when guided through the necessary steps. This comprehensive guide provides you with clear instructions to successfully complete the form online.
Follow the steps to accurately fill out the MO MO 780-1231 form.
- Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
- Begin by entering your Public Water System (PWS) name and identification number in the designated fields. Ensure that these details are accurate as they are crucial for identification.
- Fill in the county and website of the public water system. This information helps in tracking and identifying the service area.
- In the dates and certification section, specify the activation or deactivation date along with the number of service connections. Indicate whether the service connections are activated or deactivated.
- Document the population metrics by indicating the retail population served and the estimated total population. This information is significant for public health considerations.
- Select the ownership type among the provided options and specify the percentage of each source type used for water provision.
- Outline the system capacity and average daily production. Fill in the total design capacity and emergency production quantities to detail the system's capabilities.
- Move to the geographic areas served section, indicating the city or area served by this public water system.
- Enter the system address details, ensuring to include the complete address for service identification. Avoid using P.O. Boxes.
- Finally, ensure that you complete the contact information fields, including your email address and phone numbers. Review all entries for accuracy.
- Once completed, you can save your changes, download, or print the form as needed for your records or further processing.
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