ATTACHMENT 3
Generating Facility Pre-Application Report Form
Preamble and Instructions
An Interconnection Customer who requests a Pre-Application Report must submit this
Pre-Application Report Request by hand delivery, mail, e-mail, or fax to the Utility
along with the non-refundable fee of $300.
DISCLAIMER: Be aware that this Pre-Application Report is simply a snapshot in
time and is non- binding. System conditions can and do change frequently.
Check here if payment is enclosed. Fee is required for application to be
considered complete.
Date:
_________________
q
Interconnecting Customer Name (print):
Contact Person:
Mailing Address:
City: ________________________________ State: ______________ Zip Code: __________
Telephone (Daytime):
E-Mail Address:
Alternative Contact Information (e.g., system installation contractor or
coordinating company) Name (print):
Role:
Contact Person:
Mailing Address:
City: ________________________________ State: ______________ Zip Code: __________
Telephone (Daytime):
E-Mail Address:
Facility Information:
1) Proposed Facility Location
Address (or cross-roads):
City: ________________________________ State: ________ Zip Code: __________
q Site Map provided (Google, MapQuest, etc.)
NC Pre-Application
Report Form
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q Grid Coordinates - Latitude: ______________ Longitude: ______________
q Pole or Tower number if available:
2) Primary Energy Source
Choose one:
Renewable
1. Solar – Photovoltaic
2. Solar – thermal
3. Biomass – landfill gas
4. Biomass – manure digester gas
5. Biomass – directed biogas
6. Biomass – solid waste
7. Biomass – sewage digester gas
8. Biomass – wood
9. Biomass – other (specify below)
10. Hydro power – run of river
11. Hydro power - storage
12. Hydro power – tidal
13. Hydro power – wave
14. Wind
15. Geothermal
16. Other (specify below)
Non-Renewable
17. Fossil Fuel - Diesel
18. Fossil Fuel - Natural Gas (not
waste)
19. Fossil Fuel - Oil
20. Fossil Fuel – Coal
21. Fossil Fuel – Other (specify
below)
22. Other (specify below)
3) Prime Mover Choose one:
1.
2.
3.
4.
Photovoltaic (PV)
Fuel Cell
Reciprocating Engine
Gas Turbine 5.
6.
7.
4) Type of Generator
Choose one:
1.
2.
3.
Inverter-based Machine
Rotating Machine
Rotating Machine with Inverters 5) Size:
kW AC
6) Generator Configuration:
q Single-phase
q Three Phase
NC Pre-Application
Report Form
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Steam Turbine
Micro-turbine
Other, including Combined Heat and
Power (specify below) 7) Interconnection Configuration
q New Generation
q Stand-alone
q Addition to existing commercial or industrial customer’s delivery
Customer’s Electric Utility account number: ___________________
Customer’s Electric meter number: _________________________
Is Customer’s kW load going to increase or decrease?
q No
q Yes, Details ______________________________________
Proposed Point of Interconnection on Customer-side of Utility meter
__________________________________________________________
***OR***
q Addition to existing generation
q Stand-alone
q Addition to existing commercial or industrial customer’s delivery
Customer’s Electric Utility account number: ___________________
Customer’s Electric meter number: _________________________
Is Customer’s kW load going to increase or decrease?
q No
q Yes, Details ______________________________________
Type of Existing Generation: ______________________________
Size of Existing Generation: ____________ kWAC
Proposed Point of Interconnection on Customer-side of Utility meter
__________________________________________________________
Additional Comments
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
NC Pre-Application
Report Form
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