Small Generator Interconnection Request Application Form

Member Information

Member Name:

Designated Contact Person:*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number:*

Fax:

E-mail Address:*

An interconnection Request is considered complete when it provides all applicable and correct information required on the following pages.

Legal Name of the Interconnection Customer (or, if an individual, individual's name):

Name:*

Contact Person:*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Facility Location (if different from above):

Phone Number (Day):*

Phone Number (Evening):*

Fax:

Email Address:*

Alternative Contact Information (if different from the Interconnection Customer)

Name:

Contact Person:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number (Day):

Phone Number (Evening):

Fax:

Email Address:

Application Is For:*

New Small Generating Facility

Capacity addition to Existing Small Generating Facility

Will the Small Generating Facility be used for any of the following?

Net Metering

To Supply Power to the Interconnection Customer

To Supply Power to Others

For installations at locations with existing electric service to which the proposed Small Generating Facility will interconnect, provide:

Local Electric Service Provider:

Existing Account Number:

Contact Name:

Title:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number (Day):

Phone Number (Evening):

Fax:

Email Address:

Requested Point of Interconnection:*

Interconnection Customer's Requested In-Service Date:*

Max design fault contribution current:

Instantaneous or RMS?

Harmonics Characteristics:

Start-up requirements:

Small Generating Facility Characteristic Data (for rotating machines)

RPM Frequency:

(*) Neutral Grounding Resistor (If Applicable):

Synchronous Generators:

Direct Axis Synchronous Reactance, Xd:

Direct Axis Transient Reactance, X' d:

Direct Axis Subtransient Reactance, X" d:

Negative Sequence Reactance, X2:

Zero Sequence Reactance, X0:

KVA Base:

Field Volts:

Field Amperes:

Induction Generators:

Motoring Power (kW):

I2 2t or K (Heating Time Constant):

Rotor Resistance, Rr:

Stator Resistance, Rs:

Stator Reactance, Xs:

Rotor Reactance, Xr:

Magnetizing Reactance, Xm:

Short Circuit Reactance, Xd'':

Exciting Current:

Temperature Rise:

Frame Size:

Design Letter:

Reactive Power Required In Vars (No Load):

Reactive Power Required In Vars (Full Load):

Total Rotating Inertia, H:

Note: Please contact the Member prior to submitting the Interconnection Request to determine if the specified information above is required.

Excitation and Governor System Data for Synchronous Generators Only:

Provide appropriate IEEE model block diagram of excitation system, governor system and power system stabilizer (PSS) in accordance with the regional reliability council criteria. A PSS may be determined to be required by applicable studies. A copy of the manufacturer's block diagram may not be substituted.

Interconnection Facilities Information

Will a transformer be used between the generator and the point of common coupling?

Yes

No

Will the transformer be provided by the Interconnection Customer?

Yes

No

Transformer Data (If Applicable, for Interconnection Customer-Owned Transformer):

Is the transformer...?

Single Phase

Three Phase

Size (kVA):

Transformer Impedance

%

on kVA base

Transformer Fuse Data (If Applicable, for Interconnection Customer-Owned Fuse):

(Attach copy of fuse manufacturer's Minimum Melt and Total Clearing Time-Current Curves)

Max. file size: 256 MB.

Manufacturer:

Type:

Size:

Speed:

Interconnecting Circuit Breaker (if applicable):

Manufacturer:

Type:

Load Rating (Amps):

Interrupting Rating (Amps):

Trip Speed (Cycles):

Interconnection Protective Relays (If Applicable):

If Microprocessor-Controlled:

List of Functions and Adjustable Setpoints for the protective equipment or software:

Setpoint Function

Minimum

Maximum

If Discrete Components:

(Enclose Copy of any Proposed Time-Overcurrent Coordination Curves)

Manufacturer Type:

Style/Catalog No.:

Proposed Setting:

Current Transformer Data (If Applicable):

(Enclose Copy of Manufacturer's Excitation and Ratio Correction Curves)

Max. file size: 256 MB.

Current Transformer Data (If Applicable):

Manufacturer:

Type:

Accuracy Class:

Proposed Ratio Connection:

Potential Transformer Data (If Applicable):

Manufacturer:

Type:

Accuracy Class:

Proposed Ratio Connection:

General Information

Enclose copy of site electrical one-line diagram showing the configuration of all Small Generating Facility equipment, current and potential circuits, and protection and control schemes. This one-line diagram must be signed and stamped by a licensed Professional Engineer if the Small Generating Facility is larger than 50 kW.

Is One-Line Diagram Enclosed?

Yes

No

Enclose copy of any site documentation that indicates the precise physical location of the proposed Small Generating Facility (e.g., USGS topographic map or other diagram or documentation).

Max. file size: 256 MB.

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Enclose copy of any site documentation that describes and details the operation of the protection and control schemes.

Max. file size: 256 MB.

Is Available Documentation Enclosed?

Yes

No

Enclose copies of schematic drawings for all protection and control circuits, relay current circuits, relay potential circuits, and alarm/monitoring circuits (if applicable).

Max. file size: 256 MB.

Are Schematic Drawings Enclosed?

Yes

No

Applicant Signature

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

Signature

Certification of Small Generator Equipment Packages

1.0 Small Generating Facility equipment proposed for use separately or packaged with other equipment in an interconnection system shall be considered certified for interconnected operation if (1) it has been tested in accordance with industry standards for continuous utility interactive operation in compliance with the appropriate codes and standards referenced below by any Nationally Recognized Testing Laboratory (NRTL) recognized by the United States Occupational Safety and Health Administration to test and certify interconnection equipment pursuant to the relevant codes and standards listed in SGIP Attachment 3, (2) it has been labeled and is publicly listed by such NRTL at the time of the interconnection application, and (3) such NRTL makes readily available for verification all test standards and procedures it utilized in performing such equipment certification, and, with consumer approval, the test data itself. The NRTL may make such information available on its website and by encouraging such information to be included in the manufacturer’s literature accompanying the equipment.

2.0 The Interconnection Customer must verify that the intended use of the equipment falls within the use or uses for which the equipment was tested, labeled, and listed by the NRTL.

3.0 Certified equipment shall not require further type-test review, testing, or additional equipment to meet the requirements of this interconnection procedure; however, nothing herein shall preclude the need for an on-site commissioning test by the parties to the interconnection nor follow-up production testing by the NRTL.

4.0 If the certified equipment package includes only interface components (switchgear, inverters, or other interface devices), then an Interconnection Customer must show that the generator or other electric source being utilized with the equipment package is compatible with the equipment package and is consistent with the testing and listing specified for this type of interconnection equipment.

5.0 Provided the generator or electric source, when combined with the equipment package, is within the range of capabilities for which it was tested by the NRTL, and does not violate the interface components' labeling and listing performed by the NRTL, no further design review, testing or additional equipment on the customer side of the point of common coupling shall be required to meet the requirements of this interconnection procedure.

6.0 An equipment package does not include equipment provided by the utility.

7.0 Any equipment package approved and listed in a state by that state’s regulatory body for interconnected operation in that state prior to the effective date of these small generator interconnection procedures shall be considered certified under these procedures for use in that state.

Data to Be Provided by the Interconnection Customer with the Facilities Study Agreement

Provide location plan and simplified one-line diagram of the plant and station facilities. For staged projects, please indicate future generation, distribution circuits, etc. On the one-line diagram, indicate the generation capacity attached at each metering location. (Maximum load on CT/PT) On the one-line diagram, indicate the location of auxiliary power. (Minimum load on CT/PT) Amps

One set of metering is required for each generation connection to the new ring bus or existing Member station. Number of generation connections:One set of metering is required for each generation connection to the new ring bus or existing Member station. Number of generation connections:

Will an alternative source of auxiliary power be available during CT/PT maintenance?

Yes

No

Will a transfer bus on the generation side of the metering require that each meter set be designed for the total plant generation?

Yes

No

What type of control system or PLC will be located at the Small Generating Facility?

What protocol does the control system or PLC use?

Please provide a 7.5-minute quadrangle map of the site. Indicate the plant, station, distribution line, and property lines.

Physical dimensions of the proposed interconnection station:

Bus length from generation to interconnection station:

Line length from interconnection station to Member's Distribution System.

Tower number observed in the field. (Painted on tower leg)*:

Number of third party easements required for distribution lines*:

* To be completed in coordination with Member.

Is the Small Generating Facility located in Member’s service area?

Yes

No

Please provide the following proposed schedule dates:

Begin Construction Date:

Generator step-up transformers receive back feed power Date:

Generation Testing Date:

Commercial Operation Date:

Small Generator Interconnection Request Application Form

Member Information

Legal Name of the Interconnection Customer (or, if an individual, individual's name):

Alternative Contact Information (if different from the Interconnection Customer)

Small Generating Facility Information

Generator (or solar collector) Information

Individual Generator Power Factor

Small Generating Facility Characteristic Data (for rotating machines)

Synchronous Generators:

Induction Generators:

Interconnection Facilities Information

Transformer Data (If Applicable, for Interconnection Customer-Owned Transformer):

Transformer Fuse Data (If Applicable, for Interconnection Customer-Owned Fuse):

Interconnecting Circuit Breaker (if applicable):

Interconnection Protective Relays (If Applicable):

Current Transformer Data (If Applicable):

Potential Transformer Data (If Applicable):

General Information

Applicant Signature

Certification of Small Generator Equipment Packages

Data to Be Provided by the Interconnection Customer with the Facilities Study Agreement

Please provide the following proposed schedule dates:

Net Metering Workbook