Bronafon Bridge Street Llanfyllin, Powys, SY22 5AU Tel: 01691 648 378 www.greenearthhydro.co.uk Company Registration Number 7417466 Hydro Power Customer Self Survey Form Thank you for your enquiry. It will help us to assess the suitability of your project if you could complete our questionnaire and return it to us. 1. Customer details Date Name Address Postcode Email Tel Mobile 2. Turbine & Intake - Possible Sites Proposed Turbine Site – Or the lowest point of the water course on your land. Please give a 10 figure OS grid reference e.g. SN 76000 84800 Proposed Intake Site – Or the highest point of the water course on your land. Please give a 10 figure OS grid reference e.g. SN 76000 84800 Height of Water Drop – Approximate vertical height from water intake to turbine (metres) Length of Water Drop – Approximate distance overland from water intake to turbine (metres) 3. Flow Rate If you know the average flow rate for the water course please enter it here Does the water course dry up in the summer? If you don’t know the average flow rate, please say very approximately how wide and how deep the water course is, just to give us a rough idea of its size 4. Land Ownership Do you own both banks of the water course? 5. Electrical Connection Do you have an electricity supply near the turbine site? Are you considering an off-grid (battery) system? What is your annual electricity consumption? Please give either the number of units (kWh) or the amount you spend per year. GEE.HYDRO.06.V10 Page 1 of 2 04.07.14 6. Other Notes & Comments Please use this section to tell us anything about the scheme that you think is relevant, such as any correspondence you have had with the Environment Agency, whether the water course has any particular conservation status (SSSI, etc). Please attach a photo of the water course, if possible. 7. Admin How did you hear about Greenearth Hydro Limited? There is a considerable amount of work involved in a preliminary site survey for a hydro system, and therefore we do charge £420 + mileage + VAT for this service. GEE.HYDRO.06.V10 Page 2 of 2 04.07.14