Small Generator Interconnection Pre-Application Report Request Form

SMALL GENERATOR INTERCONNECTION PRE-APPLICATION REPORT REQUEST FORM

Overview

The Interconnection Customer submits this request to obtain a Small Generator Pre-Application Report pursuant to Arizona Public Service Company’s (APS) Open Access Transmission Tariff (OATT). The fee for a Pre-Application Report Request is $300. Please submit the form along with the information in the request for and site map.

1. Requester/Applicant Information

Date of Request:
Requester Name/Title:
Mailing Address:
City: / State: / 9 Digit Zip Code
Phone Number: / Email Address:
Representative of Interconnection Customer to Contact:
Phone Number: / Email Address:

2. Interconnection Information

Project Name:

Requested In-Service Date (Month, Day and Year):

This Pre-Application Report Request is for (check one):

☐A proposed new Generating Facility

☐An increase in the generating capacity or a Material Modification of an existing Generating Facility

This Pre-Application Report Request is for (check one):

☐A project that will export power to APS’s Transmission System

☐A project that will not export power to APS’s Transmission System

3.Interconnection Information from Applicant

Address or location of the small generator interconnection:

Approximate proposed Point of Interconnection. The proposed Point of Interconnection shall be defined by latitude and longitude, site map, street address, utility equipment number (e.g. pole number), meter number sufficient to clearly identify the location of the Point of Interconnection. In the case of an existing Generating Facility, the name and specific location, including county of the facility is needed.

______

______

Project Location (Street Address, and latitude and longitude):

Utility Equipment Number (e.g. nearest pole number):

Proposed Nominal Service Voltage:

Please attach a site map for the proposed project to include project location, including general area of project, proposed service point location, major roads, streets and or highways, and true north symbol.

4. Generation Technology

Generation technology, fuel source (i.e. gas turbine, hydro turbine, wind turbine and MW; etc.)

☐Cogeneration MW

☐Reciprocating Engine MW

☐Biomass MW

☐Steam Turbine MW

☐Gas Turbine MW

☐Wind Turbine MW

☐Combined Cycle MW

☐Inverter Based (e.g. Photovoltaic, fuel cell) MW

If fuel cell technology, please describe primary fuel source:

______

☐Other (please describe):______MW

5. Non-Refundable Processing Fee: $300

6. Submittal:

This Interconnection Pre-Application Report Request shall be submitted to the representative indicated below:

Interconnects Development

Robert Bean, Section Leader

PO Box 53999 MS 9659

Phoenix AZ 85072 3999

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