Ill. Admin. Code tit. 83, pt. 466, app C
Level 2, Level 3 & Level 4
Interconnection Request Application Form
(Greater than 25 kW to 10 MVA or less)
Interconnection Customer Contact Information
Name: _____________________________________________________
Mailing Address: _____________________________________________
City: _______________________ State: _________ Zip Code: _________
Telephone (Daytime): _________ (Evening): _________
Facsimile Number: _________ E-Mail Address: _________
Alternative Contact Information (if different from Customer Contact Information)
Name: _____________________________________________________
Mailing Address: _____________________________________________
City: ______________________ State: _________ Zip Code: __________
Telephone (Daytime): _________________ (Evening): ________________
Facsimile Number: ___________________ E-Mail Address: ____________
Facility Address (if different from above):________________________________________
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: _________________
Equipment Contractor
Name: _____________________________________________________
Mailing Address: _____________________________________________
City: ______________________ State: _________ Zip Code: __________
Telephone (Daytime): _________________ (Evening): ________________
Facsimile Number: __________________ E-Mail Address: _____________
Electrical Contractor (if different from Equipment Contractor)
Name: _____________________________________________________
Mailing Address: _____________________________________________
City: _____________________ State: _________ Zip Code: __________
Telephone (Daytime): ________________(Evening): _________________
Facsimile Number: __________________ E-Mail Address: ____________
License Number: ____________________________________________
Electric Service Information for Customer Facility Where Generator Will Be Interconnected
Intent of Generation
Offset Load (Unit will operate in parallel, but will not export power to EDC)
Net Meter (Unit will operate in parallel and will export power pursuant to Illinois Net Metering or other filed tariffs)
Wholesale Market Transaction (Unit will operate in parallel and participate in PJM or MISO markets pursuant to a PJM Wholesale Market Participation Agreement or MISO equivalent)
Back-up Generation (Units that temporarily operate in parallel with the electric distribution system for more than 100 milliseconds)
Note: Backup units that do not operate in parallel for more than 100 milliseconds do not need an interconnection agreement.
Generator & Prime Mover Information
ENERGY SOURCE (Hydro, Wind, Solar, Process Byproduct, Biomass, Oil, Natural Gas, Coal, Storage, etc.): | ||
ENERGY CONVERTER TYPE (Wind Turbine, Photovoltaic Cell, Fuel Cell, Steam Turbine, etc.): | ||
GENERATOR SIZE: kW or kVA | NUMBER OF UNITS: | TOTAL CAPACITY: kW or kVA |
GENERATOR TYPE (Check one): InductionInverterSynchronousOther | ||
Requested Procedure Under Which to Evaluate Interconnection Request1
Please indicate below which review procedure applies to the interconnection request. The review procedure used is subject to confirmation by the EDC.
Level 2 - Lab-certified interconnection equipment with an aggregate electric nameplate capacity not exceeding the specifications in Section 466.90(b)(2). Lab-certified is defined in Section 466.20. (Application fee is $100 plus $1.00 per kVA.)
Level 3 - Distributed energy resource facility does not export power. Nameplate capacity rating is less than or equal to 50 kW if connecting to area network or less than or equal to 10 MW if connecting to a radial distribution feeder. (Application fee amount is $500 plus $2.00 per kVA.)
Level 4 - Nameplate capacity rating is less than or equal to 10 MVA and the distributed energy resource facility does not qualify for a Level 1, Level 2 or Level 3 review, or the distributed energy resource facility has been reviewed but not approved under a Level 1, Level 2 or Level 3 review. (Application fee amount is $1,000 plus $2.00 per kVA, to be applied toward any subsequent studies related to this application.)
1 Note: Descriptions for interconnection review categories do not list all criteria that must be satisfied. For a complete list of criteria, please refer to 83 Ill. Adm. Code 466, Electric Interconnection of Distributed Generation Facilities.
Distributed Energy Resource Facility Information
Commissioning Date: _________________________________
List interconnection components/systems to be used in the DER facility that are lab-certified.
Component/SystemNRTL Providing Label & Listing
1. ______________________________________________________________________
2. ______________________________________________________________________
3. ______________________________________________________________________
4. ______________________________________________________________________
5. ______________________________________________________________________
Please provide copies of manufacturer brochures or technical specifications.
Other Facility Information:
One Line Diagram attached: Yes
Plot Plan attached: Yes
Battery Storage Facility Information (If Applicable)
Do the batteries share an inverter with a renewable energy system? [] Yes [] No
Does the applicant intend to have the batteries charged by the distribution grid? [] Yes [] No
System Manufacturer: _____________________________________________
Model: _________________________________________________________
Battery Type: ____________________________________________________
Battery Charge/Discharge Rating (kW AC): _____________________________
Maximum Battery Charge/Discharge Rate (kW AC per second): ______________
Battery Energy Capacity (kWh): _______________________________________
Power Factor Settings Range: ________________________________________
Battery Storage Inverter Information
Energy System Type: [] Forced []
Manufacturer: ____________ Model: ______ Commutated
Line
Commutated
Rated Output Watts: ____ Volts: ____ Efficiency: ____ % Power Factor: ____ %
Inverter IEEE 1547 / UL 1741 Listed: [] Yes [] No
Number of Inverters: ________________ Total Capacity: ____________kW__
DC Source / Prime Mover: _______ - Rating: _________ kW Rating: ________
kVA Rated Voltage: ___________Volts_
Open Circuit Voltage (If Applicable): ________Volts_
Rated Current: _____________Amps_
Battery Operational Information
Backup - allows for partial or whole home transition to off-grid during a grid outage. [] Yes [] No
Solar Self-Powered - the battery will charge from the renewable energy source during normal operation and discharge to serve loads behind your meter. [] Yes [] No
Solar Non-Export - limits the export of energy to the grid to zero for both the battery and inverter, even if the battery system is fully charged and there is excess renewable source energy. [] Yes [] No
Time-Based Control (sometimes called time-of-use or TOU mode) - the battery charges during off-peak hours and discharges to serve onsite loads during on-peak hours. [] Yes [] No
Describe any other intended operation of the battery: _______________________
________________________________________________________________
Customer Signature
I hereby certify that all of the information provided in this Interconnection Request Application Form is true.
Applicant Signature: ___________________________________________
Title: _______________________________________ Date: __________
An application fee is required before the application can be processed. Please verify that the appropriate fee is included with the application:
Amount: _____________________
EDC Acknowledgement
Receipt of the application fee is acknowledged and this interconnection request is complete.
EDC Signature: ____________________________ Date: ____________
Printed Name: ______________________ Title: ____________________
Ill. Admin. Code tit. 83, pt. 466, app C