Certificate of Completion
(To be completed and returned to the EDC when installation is complete
and final electric inspector approval has been obtained[1])
Interconnection Customer Information
Name: _____________________________________________________
Mailing Address: _____________________________________________
City: _________________ State: _________ Zip Code: ______________
Telephone (Daytime): ________________ (Evening): ________________
Facsimile Number: ________________ E-Mail Address: ______________
InstallerCheck if owner-installed
Name: ____________________________________________________
Mailing Address: ____________________________________________
City: __________________ State: _________ Zip Code: _____________
Telephone (Daytime): ________________ (Evening): ________________
Facsimile Number: ________________ E-Mail Address: ______________
Final Electric Inspection and Interconnection Customer Signature
The distributed generation facility is complete and has been approved by the local electric inspector having jurisdiction. A signed copy of the electric inspector's form indicating final approval is attached. The interconnection customer acknowledges that it shall not operate the distributed generation facility until receipt of the final acceptance and approval by the EDC as provided below.
Signed: ___________________________ Date: ___________________
(Signature of interconnection customer)
Printed Name: ____________________________
Check if copy of signed electric inspection form is attached
Check if copy of as built documents is attached (projects larger than 25 kW only)
..................................................................................................................
Acceptance and Final Approval for Interconnection (for EDC use only)
The interconnection agreement is approved and the distributed generation facility is approved for interconnected operation upon the signing and return of this Certificate of Completion by EDC:
Electric Distribution Company waives Witness
Test? (Initial) Yes(____)No(____)
If not waived, date of successful
Witness Test: __________ Passed: (Initial) ____________
EDC Signature: ____________________ Date: ____________________
Printed Name: _____________________ Title: ____________________
[1] Prior to interconnected operation, the interconnection customer is required to complete this form and return it to the EDC. Use contact information provided on the EDC's web page for generator interconnection to obtain mailing address/fax number/e-mail address.
Ill. Admin. Code tit. 83, pt. 466, app B