CLIMATE CHANGE LEVY EXEMPTION FOR RENEWABLES APPLICATION FOR ACCREDITATION Questionnaire for Generators Please note that accreditation may be refused if false or incomplete information is given and that untrue statements may result in prosecution and could lead to revocation of accreditation Revised March 2010 Name of generating station: GENERATING STATION INFORMATION 1. Name of generating station Contact name: Telephone Number: Email address: 2. Location of generating station Address OS grid reference – 2 letters and 6 figures) 3. Details of owner or operator of generating station (Note this company will be the applicant company referred to in the declaration at the end of this questionnaire). Name: Company Name: Address: Telephone Number: Email address: 4. Details of individual completing questionnaire: Name: Company Name: Address: Telephone Number: Email address: 2 Name of generating station: 5. Renewable generation technology (tick relevant box – one only) Biomass Hydro (less than 10 MW DNC) Landfill gas Municipal & Industrial Waste Off-shore wind On-shore wind Sewage gas Tidal flow Wave power Coal mine methane Photovoltaic 6. Technical specifics: i. Type, number of and electrical rating of all generating equipment and associated equipment (boilers, incinerators etc) ii. Total installed generating capacity (kW) iii. Declared net capacity iv. Details of any standby or auxiliary generation including fuel type and electrical rating v. For hydro stations, please give kW/MW rating of each turbine and the kVA/MVA rating of each alternator; please also give a description of all the civil works connected to the hydro station 7. Date renewables generating station commissioned or due to commission (month & year). 3 Name of generating station: 8. Connection arrangements (i) Is the connection agreement for this generating station with: Transmission Network Operator? Distribution Network Operator? Other Network Operator? Please state which network operator you have your connection agreement with: (i) What is the capacity (kW) of the connection? (ii) Does the station export electricity via a separate site network which may be in the same ownership as the station, but which serves other site loads that are independent of the generating station? 9. Provide and attach a schematic diagram or simple line drawing of the proposed generating station. This must include the following: (i) All generating equipment and associated auxiliary loads (ii) Other electrical loads not associated with the generating station (iii) Any standby generation and associated interlocking or switching facilities with the generating station (iv) Import and export connections and associated voltages (v) Location and details (vi) A letter or note of approval from the supplier you are contracted to confirming the viability of the schematic Tick to confirm attached: 10. Does the generating station have half hourly metering for electricity exported to the transmission or distribution network? (Yes / No) 11. Please provide the MPAN/MPRN Number(s) for the export meter: 12. Is the generating station a CHP station? (Yes / No) If “Yes” is the station (or any part thereof) covered by a CHPQA Certificate? If “Yes” state the CHP scheme reference number: 4 Name of generating station: 13. Is the generating station located outside the UK? If “Yes” is it connected either directly, or indirectly via the distribution system, to the national transmission system in the UK? If “Yes” how will the electricity represent electricity consumed in the UK? 14. Is the generating station subject to a NFFO contract? If “Yes” give the NFFO contract number 15a. Is the energy content of the fossil fuel used for one or more of the following purposes: (i) the ignition of gases of low or variable calorific value; (ii) the heating of the combustion system to its normal operating temperature or the maintenance of that temperature; (iii) emission control; (iv) in any year no more than 10% of the energy content of the renewable sources used? If “Yes” this fossil fuel use can be disregarded for the purposes of the Climate Change Levy exemption for renewable. 15b. Is fossil fuel used for any other purpose? (Yes/No) If “Yes” give details of the energy content of all fuels used and complete the following table. 5 Name of generating station: a) details of expected input renewable fuel consumption per annum Renewable Fuel type Quantity Calorific value Heat contribution % contribution to total plant heat input (c) Total b) details of expected input fossil fuel (include fuel for start-up, supplements to renewables fuels and processing of renewable fuels) per annum Fossil Fuel Type Quantity Calorific value Heat contribution % contribution to total plant heat input (d) Total Note (c) plus (d) must equal 100% 16. This question applies to generating stations fuelled wholly or partly by waste and/or biomass Applicants should provide and attach the following information: (i) (ii) (iii) (iv) Full details showing proportions of each component by weight The calorific value (in MJ/kg) of each fuel component and how this value was obtained or measured A description of any facilities, either on or off site, for sorting the fuel Name(s) and address(es) of suppliers of the fuel including extracts from relevant contract(s) in place with fuel suppliers Does the operator of the generating station believe that more than 50% of the energy content of any waste used in fuelling the generating station, is derived from fossil fuel? If “Yes” please provide details 6 Name of generating station: 17. All applicants must sign the following declaration: .CONSUMPTION DECLARATION I declare that I am duly authorised to sign this form for and on behalf of the Company, and on behalf of the Company I confirm that: A all electricity notified to the Utility Regulator for the purpose of issuing Renewables LECs as have being generated by the Generating Station during the Specified Period represents electricity consumed or to be consumed in the UK; and B for any electricity so notified, the Company is able to provide the Utility Regulator at any time, Including for the avoidance of doubt and without limitation during an audit conducted by the Utility Regulator with the evidence specified in Consumption Declaration & Associated Evidential Guidelines from time to time as being required in order for the Utility Regulator to be satisfied that the electricity represents electricity consumed or to be consumed in the UK; and C any electricity so notified has not been allocated by the Company for consumption outside the UK. On behalf of the company I acknowledge a Renewables LEC will not be issued if the Utility Regulator is at any time not satisfied that the electricity with respect to which the Renewables LEC is to be issued represents electricity consumed or to be consumed in the United Kingdom. On behalf of the company I acknowledge that I am aware that Part VIII of Schedule 6 to the Finance Act 2000 establishes criminal and civil penalties for evasion, misdeclaration and neglect in relation to the levy and in particular paragraph 93(2) of that Schedule establishes criminal offences in relation to recklessly or knowingly making materially false statements in information provided in relation to the levy. Specified Period: 1 April – 31 March Name of Generating Station: Accreditation number of the Generating Station: Name of authorised signatory: Position in Company: Company: Address, telephone number, fax number and email address: Signature: Date: 7