Microgrid Distributed Energy Resources Interconnection Form
Applicant Information
Organization Name
Contact Name
Email
Phone Number
Address
Project Location
Site Address
City
State
ZIP Code
Distributed Energy Resources (DER) Information
Type of DER
Solar PV
Wind
Battery Storage
Fuel Cell
Generator
Other
Capacity (kW)
Voltage Level
Equipment Manufacturer & Model
Interconnection Details
Requested Interconnection Date
Existing Utility Customer?
Yes
No
Utility Account Number (if any)
Description of Interconnection (including mode of operation)
Additional Information
Comments or Special Requirements