Application for Operation of Member-Owned Small Power Generation Systems (PDF Fillable) This application should be completed as soon as possible and returned to the Cooperative in order to begin processing the request. See Member Requirements for Installation and Interconnection of Small Power Generation Systems 50 kW or less for additional information. INFORMATION: This application will be used by South Central Indiana REMC to determine the required equipment configuration for the Member interface. Every effort should be made to supply as much information as possible. Incomplete applications may be returned for clarification.Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) SCI REMC Account #(Required)Project Design/Engineering (as applicable)Company(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Representative(Required) Electrical Contractor (as applicable)Company(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) Representative(Required) Generation TypeWhat is the generation type?(Required) Photovoltaic Wind Microturbine Diesel Engine Gas Engine Turbine Other Estimated Load, Generator Rating and Mode of Operation InformationThe following information will be used to help properly design the interconnection. This information is not intended as a commitment or contract for billing purposes. Total Generation Installed (in kW)(Required) Residential(Required) Commercial(Required) Industrial(Required) Battery Capacity Demand (on kW) Battery Energy (on kwh) Estimated Annual Generation (in kwh)(Required) Description of Proposted Installation and OperationGive a general description of the proposed installation, including a detailed description of its planned location and when you plan to operate the generator. Attach a single-line diagram showing the planned installation.(Required)Inverter Data (if applicable)Manufacturer(Required) Model(Required) Rater Power Factor (%)(Required) Rated Voltage (Volts)(Required) Rated Amperes(Required) IEEE 1547-2018/UL1741 Compliant(Required) Yes No Storage System Data (Batteries) (if applicable)Manufacturer(Required) Model(Required) Volt/Cell(Required) #Cells(Required) Maximum Output (kW)(Required) Power Circuit Breaker (if applicable)Manufacturer(Required) Model(Required) Rated Voltage (kilovolts)(Required) Rater Ampacity (Amperes)(Required) Interrupting Rating (Amperes)(Required) BIL Rating(Required) Additional InformationIn addition to the items listed above, please attach a detailed one-line diagram of the proposed facility, all applicable elementary diagrams, major equipment, (generators, transformers, inverters, circuit breakers, protective relays, etc.) specifications, test reports, etc., and any other applicable drawings or documents necessary for the proper design of the interconnection. Also describe the project’s planned operating mode (e.g., combined heat and power, peak shaving, etc.), and its address or grid coordinates. Drop files here or Select files Max. file size: 350 MB. Consent(Required)The Member agrees to provide the Cooperative with any additional information required to complete the interconnection. The member shall operate the equipment within the guidelines set forth by the cooperative. I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Applicant Digital Signature(Required) Today's Date(Required) MM slash DD slash YYYY
