Net Metering Application
This application is considered complete when it provides all applicable and correct information required below. Additional information to evaluate the Application may be required. A Processing Fee of $100.00 must accompany this Application.
SESD Customer
Name *
Service Address *
Mailing Address *
Phone Number *
E-Mail Address *
Contact (if different from SESD Customer)
Name
Mailing Address
Phone Number
Email *
Installation Company *
Company Address - Street, City, State, ZIP *
Inverter Manufacturer Model *
Nameplate Rating (kW)(kVA)(AC Volts) Single Phase *
Nameplate Rating (kW)(kVA)(AC Volts) Three Phase *
System Design Capacity (kW) *
System Design Capacity (kVA) *
Prime Mover *
Energy Source *
Is the equipment ULi741 Listed?
If yes, attach manufacturer's cut-sheet showing UL1741 lissting.
Estimated Installation Date *
MM
/
DD
/
YYYY
Estimated In-Service Date *
MM
/
DD
/
YYYY
The Level 1 Process is available only for inverter-based Generating Facilities no larger that 5 kW that meet the codes, standards, and certification requirements.
List components on the Small Generating Facility Equipment Package that are Currently Certified Equipment Type Certifying Entity.
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agreement
I hereby certify that, to the best of my knowledge, that information provided on this Application is true. I agree to abide by the Terms and Conditions for Level 1 interconnection for a Generating Facility No Larger than 10 kW.
SESD Customer Signature (type full name) *
Installation Company Representative Signature (type full name) *
Title *
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