Tier II Interconnection Application

This form is for Distributed Energy Resources (DERs) that meets the eligibility of a Tier II track. 
This includes backup fossil fuel generation, standalone energy storage systems and electric 
vehicles designed to provide backup service to the residence.


The Interconnection Application is to be filled out completely by the applicant or as noted in each 
section of the application. Section that are noted with * are required to be filled out along with bolded items.
 

Checklist for Submission to Area EPS Operator

The items below shall be included with submittal of the Interconnection Application to the Area EPS
Operator. Failure to include all items will deem the Interconnection Application incomplete.

(Yes)

  •  Please see Area EPS Operatorโ€™s Technical Requirement for more details.

(Yes)

  •  Please see Area EPS Operatorโ€™s Technical Requirement for more details.

Interconnection Customer/Owner *

(match name of electric service account, if applicable):

Application Agent *

Is the Customer using an Application Agent for this application?
If internconnection Customer is not using an Applicant Agent, please continue to next section.

DER Location *

Is the proposed DER system to be located at the Interconnection Customerโ€™s mailing address:
If yes, please continue to the next section.
If No, will the proposed DER system be interconnected to an existing electric service?
Please provide the address of GPS Coordinates:

Distributed Energy Resource Information *

Type of Generator (check all that apply):
Phase configuration of Distributed Energy Resource(s):
DER Type (Check all that apply and list aggregate capacity of each type):
Size (kW AC):
Size (kW AC):
Size (kW AC):
Size (kW AC):
Size (kW AC):
Size (kW AC):

Interconnection Facilities Information *

What type of DER Interconnection/Transer Method is Proposed?
None (DER is never operating parallel with the distribution system)
Limited (DER operated parallel with the distribution system for a short time). Please specify what type of Limited.
Quick Closed (100msec parallel or less)
Limited Parallel (2 minutes or less)
Will a transfer switch be used with the DER?
Will a transformer, owned by the Interconnection Customer, be used between the DER and the Point of Common Coupling?

Energy Storage System Information (if applicable)

How will the ESS be used? Select all Use Cases that apply.
What Operating Modes will be used? Select all Operating Modes that apply.
Certification
Certification
Certification
Certification

Rotating Generation System Information (if applicable) Prime Mover Information

Please indicate the prime mover:
Generator type

Distributed Energy Resource Characteristic Data (for Synchronous machines)

For Synchronous Generators 1 MW or larger, please provide the appropriate IEEE model block diagram 
of excitation system, governing system and power system stabilizer (PSS) in accordance with the 
regional reliability council criteria. A PSS may be determined to be required by applicable 
studies.  A copy of themanufacturerโ€™s block diagram may not be submitted.
 

Distributed Energy Resource Characteristic Data (for Induction machines)

Electric Vehicle System Information (if applicable)

Can the Electric Vehicle provide backup power to the electrical service?
If Yes, please fill out the transfer switch information section under Interconnection Facilities Information
Are All Charges Identical:

If Yes, please only fill out the first section of EV Charger information
 

Phase configuration of Charger:
EV Charger Level:
Voltage of Charger:
Phase configuration of Charger:
EV Charger Level:
Voltage of Charger:

Application Signature โ€“ Must be completed by Interconnection Customer *

Sign above

ย 

BY SIGNING, THE MEMBER ACKNOWLEDGES THAT THEY HAVE READ THIS AGREEMENT AND AGREE TO BE BOUND BY ITS TERMS