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Cobb EMC Energy Network

Interconnect Application

Contractor Form

Appendix 5

Project Information

Note: Please contact the Cooperative prior to submitting the Interconnection Request to determine if the below is applicable.

General Information

Application Number (can be found in the email you received which linked to this form):

**

Company Name

*

Contractor License number

*

Contact Name

**

Title

**

E-mail Address

***

Mailing Address

**

City

**

State

**

Zip Code

*

Telephone (Day)

*

Telephone (Evening)

*

Fax

*

Square Footage of Roof

*

Inverter Manufacturer

*

Model

*

Do you have the OEM information to attach? This should include the listing.

**

*

*

*

*

*

*

*

*

*

*

Nameplate Rating - kW

*

Nameplate Rating - kVA

*

Nameplate Rating - AC Volts

*

System Design Capacity - kW

*

System Design Capacity - kVA

*

Phase

Phase Single PhasePhase Three Phase

Generating Type (i.e. solar, wind, fuel cell, battery, etc.)

*

ONE LINE DIAGRAM ENCLOSED?

**

*

*

*

*

*

*

*

*

*

*

EQUIPMENT INFORMATION INCLUDED?

**

*

*

*

*

*

*

*

*

*

*

SITE PLAN ENCLOSED?

**

*

*

*

*

*

*

*

*

*

*

Battery Information

Manufacturer

*

Type of Chemistry

*

C rating

*

Total number of batteries:

**

Ground or Ungrounded:

Ground or Ungrounded: GroundedGround or Ungrounded: Ungrounded

Primary Usage

*

DC fused protection manufacturer:

*

Model

*

Rating at 3ms

*

Photovoltaic Information

Manufacturer

*

Type of panel

*

Power rating (summer and winter)

*

Number of Panels

**

Tilt (fixed, tracking, or other if fixed provide angle)

*

Orientation

*

GPS Coordinates of site:

*

Other Resource Information

Electrical Information

Max design fault contribution current:

Max design fault contribution current: InstantaneousMax design fault contribution current: RMS

Harmonics Characteristics:

*

Start-up requirements

*

Inverter Equivalent MVA Base:

*

Short-Circuit Equivalent Pos. Seq. Resistance (R1):

*

Short-Circuit Equivalent Pos. Seq. Reactance (XL1):

*

Short-Circuit Equivalent Zero. Seq. Resistance (R2) cycles:

*

Short-Circuit Equivalent Neg. Seq. Reactance (XL2), valid for initial 2 to 6 cycles:

*

Special notes regarding short-circuit modeling assumptions:

*

Transformer and Protection Information

Will the transformer be provided by the Member Generator?

Will the transformer be provided by the Member Generator? NoWill the transformer be provided by the Member Generator? Yes

Is the transformer:

Is the transformer: Single phase Is the transformer: Three phase

Size

*

Transformer Impedance

*

kVA Base

*

Transformer Primary Winding

*

Transformer Info - Winding Type DeltaTransformer Info - Winding Type WYE grounded neutralTransformer Info - Winding Type WYE ungrounded neutral

Primary Wiring Connection

Primary Wiring Connection 3-wire Primary Wiring Connection 4-wire grounded neutral

Transformer Secondary Winding

*

Transformer Info - 2nd Winding Type DeltaTransformer Info - 2nd Winding Type WYE grounded neutralTransformer Info - 2nd Winding Type WYE ungrounded neutral

Secondary Wiring Connection

Secondary Wiring Connection 3-wire Secondary Wiring Connection 4-wire grounded neutral

Transformer Tertiary Winding

*

Transformer Info - 3rd Winding Type DeltaTransformer Info - 3rd Winding Type WYE grounded neutralTransformer Info - 3rd Winding Type WYE ungrounded neutral

Transformer Fuse Data (if applicable, for Interconnection Customer-owned fuse):

**

*

*

*

*

*

*

*

*

*

*

Manufacturer:

*

Type

*

Size

*

Speed

*

Circuit Protection and relaying schemes

Device reference:

*

Purpose

*

Manufacturer

*

Type (breaker, fuse, PT etc.):

*

Ratings: Interrupt

*

Load

*

Trip Speed

*

Setpoints (min max):

*

Accuracy

*

Ratio

*

Class

*

Device reference:

*

Purpose

*

Manufacturer

*

Type (breaker, fuse, PT etc.):

*

Ratings: Interrupt

*

Load

*

Trip Speed

*

Setpoints (min max):

*

Accuracy

*

Ratio

*

Class

*

Device reference:

*

Purpose

*

Manufacturer

*

Type (breaker, fuse, PT etc.):

*

Ratings: Interrupt

*

Load

*

Trip Speed

*

Setpoints (min max):

*

Accuracy

*

Ratio

*

Class

*

Device reference:

*

Manufacturer

*

Purpose

*

Type (breaker, fuse, PT etc.):

*

Ratings: Interrupt

*

Load

*

Trip Speed

*

Setpoints (min max):

*

Accuracy

*

Ratio

*

Class

*

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