Preliminary Interconnection Site Review Request

Customer Information

Name*

Contact Person*

Mailing Address*

City*

State*

ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Please Specify

Zip Code*

Facility Location (if different from above)

Daytime Phone*

Evening Phone

E-Mail Address*

Fax

Is requested point of interconnection the same as an existing electric service?*

Yes No

Electric Service Account Number*

Additional Customer Accounts to be credited with Net Excess Generation

Annual Energy Requirements (kWh) in the previous twelve (12) months for the account physically attached to the Net-Metering Facility and for any additional accounts listed (in the absence of historical data reasonable estimates for the class and character of service may be made)*

Type of Facility (check one)*

Customer-owned Leased Service Agreement

Please Specify

Owner Information

Name

Contact Person

Mailing Address

City

State

ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Please Specify

Zip Code

Daytime Phone

Evening Phone

E-Mail Address

Fax

Generation Facility Information

System Type (check all that apply)*

Solar Wind Hydro Geothermal Biomass Fuel Cell Micro Turbine Energy Storage Device

Please Specify

Generator Rating (kW) DC*

Inverter Rating (kW) AC*

Expected Capacity Factor*

Expected annual production (kWh) of the facility calculated using industry recognized simulation model (PVWatts, etc.)*

Interconnection Information

Customer-Site Load (kW) at Net-Metering Facility location (if none, so state)*

Interconnection Request (choose one)*

Single Phase Three Phase

Please Specify

Signature

I hereby certify that, to the best of my knowledge, all the information provided in this Preliminary Interconnection Site Review is true and correct.

Net-Metering Owner Name*

Solar Company Representative*

Solar Company Name*

Solar Representative E-Mail*

recaptcha

Submit

 

TERMS AND CONDITIONS

Section 1. Requirements for Request

For the purpose of requesting that the Cooperative conduct a preliminary interconnection site review for
a proposed Net-Metering Facility pursuant to the requirement of Rule 2.06.B.4, or as otherwise
requested by the customer, the customer shall notify the Cooperative by submitting a completed
Preliminary Interconnection Site Review Request. The customer shall submit a separate Preliminary
Interconnection Site Review Request for each point of interconnection if information about multiple
points of interconnection is requested. Part 1, Standard Information, Sections 1 through 4 of the
Preliminary Interconnection Site Review Request must be completed for the notification to be valid. If
mailed, the date of notification shall be the third day following the mailing of the Preliminary
Interconnection Site Review Request. The Cooperative shall provide a copy of the Preliminary
Interconnection Site Review Request to the customer upon request.

Section 2. Utility Review

Following submission of the Preliminary Interconnection Site Review Request by the customer the
Cooperative shall review the plans of the facility interconnection and provide the results of its review to
the customer, in writing, within 30 calendar days. If the customer requests that multiple interconnection
site reviews be conducted the Cooperative shall make reasonable efforts to provide the customer with
the results of the review within 30 calendar days. If the Cooperative cannot meet the deadline it will
provide the customer with an estimated date by which it will complete the review. Any items that
would prevent Parallel Operation due to violation of safety standards and/or power generation limits
shall be explained along with a description of the modifications necessary to remedy the violations.

The preliminary interconnection site review is non-binding and need only include existing data and
does not require the Cooperative to conduct a study or other analysis of the proposed interconnection
site in the event that data is not readily available. The Cooperative shall notify the customer if
additional site screening may be required prior to interconnection of the facility. The customer shall be
responsible for the actual costs for conducting the preliminary interconnection site review and any
subsequent costs associated with site screening that may be required.

Section 3. Application to Exceed 1,000 kW Net-Metering Facility Size Limit

This Preliminary Interconnection Site Review Request and the results of the Cooperative’s review of the facility interconnection shall be filed with the Commission with the customer’s application to exceed the 1,000 kW facility size limit pursuant to Net Metering Rule 2.06.B.4.

Section 4. Standard Interconnection Agreement

The preliminary interconnection site review does not relieve the customer of the requirement to execute a Standard Interconnection Agreement prior to interconnection of the facility.