Utility:
Customer:
Name: _________________________________________________
Address: _______________________________________________
_______________________________________________
_______________________________________________
Utility Account No.: ____________________________________
Agent (if any):
Name: _______________________________________________
Address: _____________________________________________
_______________________________________________
Consulting Engineer or Contractor:
Name: ________________________________________________
Address:______________________________________________
______________________________________________
Estimated In-Service Date: _____/_____/__________
Existing Electric Service:
Capacity: __________ Amperes
Voltage: __________ Volts
Service Character: ( ) Single Phase ( ) Three Phase
Secondary 3 Phase Transformer Connection: ( ) Wye ( ) Delta
Phone: ( _____ ) ________________________________________
Fax: ( _____ ) ___________________________________________
Email: _________________________________________________
Municipality: __________________________________________
Utility Meter No.: ______________________________________
Phone: ( _____ ) _____________________________________
Fax: ( _____ ) _________________________________________
Email: _______________________________________________
Phone: ( ) ________________________________________
Fax: ( _____ ) _________________________________________
Email: _______________________________________________
Location of Protective Interface Equipment on Property:
(Include address if different from customer address.)
Energy Producing Generator Unit Information:
Manufacturer: _______________________
Model No.: ___________________________ Version No.: _____________
( ) Synchronous ( ) Induction ( ) Other
Rating: _____ kW Rating: _____ kVA
Rated Output: _____ VA Rated Voltage: _____ Volts
Rated Frequency: _____ Hz Rated Speed: _____ RPM
Efficiency: _____ % Power Factor: _____ %
Rated Current: _____ Amps Locked Rotor Current: _____ Amps
Synchronous Speed: _____ RPM Winding Connection: _____________
Min. Operating Freq./Time: __________
Generator Connection: ( ) Delta ( ) Wye ( ) Wye Grounded
Three-Line Diagram attached: ( ) Yes
Verification Test Plan attached: ( ) Yes
If applicable, Certification to UL 1741 attached: ( ) Yes
For Synchronous Machines:
Submit copies of the Saturation Curve and the Vee Curve
( ) Salient ( ) Non-Salient
Torque: ________ lb-ft Rated RPM:
Field Amperes: ________ at rated generator voltage and current
and ________ % PF over-excited
Type of Exciter: ______________________________________
Output Power of Exciter: ____________________________
Type of Voltage Regulator: ___________________________
Direct-axis Synchronous Reactance (Xd): ________ ohms
Direct-axis Transient Reactance (X’d): ________ ohms
Direct-axis Sub-transient Reactance (X’’d): ________ ohms
For Induction Machines:
Rotor Resistance (Rr): _______ ohms Exciting Current: _______ Amps
Rotor Reactance (Xr): _______ ohms Reactive Power Required:
Magnetizing Reactance (Xm): _______ ohms, _______ VARs (No Load)
Stator Resistance (Rs): _______ ohms, _______ VARs (Full Load)
Stator Reactance (Xs): _______ ohms
Short Circuit Reactance (X’’d): _______ ohms,
Phases: ( ) Single Phase ( ) Three Phase
Frame Size: Design Letter:
Temp. Rise: _____ °C
Step Up Transformer Winding Configuration:
( ) Wye-Wye ( ) Wye-Delta ( ) Delta-Wye
Signature:
_____________________________________________________________ ______________________________________ __________________
CUSTOMER/AGENT SIGNATURE TITLE DATE