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Interconnection Request Application Form and Conditional Agreement to InterconnectIllinois • April 6th, 2017
Facility Address: City: State: Zip Code: Electric Distribution Company (EDC) serving Facility site: Electric Supplier (if different from EDC): Account Number of Facility site (existing EDC customers): Inverter Manufacturer: Model: Is the inverter lab-certified as that term is defined in the Illinois Distributed Generation Interconnection Standard? Yes No (If yes, attach manufacturer's technical specifications and label information from a nationally recognized testing laboratory.) Generation Facility Nameplate Rating: (kW) (kVA) (AC Volts) Prime Mover: Photovoltaic Reciprocating Engine Fuel Cell Turbine Other Energy Source: Solar Wind Hydro Diesel Natural Gas Fuel Oil Other Commissioning Date:
