GreyStone Power Corporation

Application for Interconnection of Distributed Generation

Complete this form, read and sign, then submit the form by clicking the "Submit Form" button at bottom.

Fields with * are required fields.

This application should be completed and submitted at least 30 days prior to the member's proposed interconnection date in order to begin processing the request. Members must not operate their distributed generation facilities in parallel with GreyStone Power's distribution system until they have received authorization from GreyStone Power. Unauthorized parallel operation of member's distributed generation facilities could result in injury to persons and/or damage to equipment or property.

Member/Applicant Information

*Member Name:
*Address:
*City:
*State:
*Zip Code:
*Phone Number:
*Email Address:

Electrical Contractor

The system will be installed in accordance with the manufacturer's specifications as well as all applicable provisions of the National Electrical Code and meet all local permitting guidelines.

*Company Name:
*Address:
*City:
*State:
*Zip Code:
*Licensed Electrician Name:
*License Number:
*Phone Number:
*Email Address:

Generating Facility Information

Supporting documentation/contractor invoice to be provided to GreyStone.

*Solar Installer:
*Contact Name:
*Phone Number:
*Email Address:
*Generator Manufacturer:
*Model Name and Number:
*Inverter Manufacturer:
*Type:
*Total Power Rating in Kilowatts:
*Direct Current (kW):
*Alternating Current (kW):
*Estimated Installation Date:	(MM/DD/YYYY)
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*Enter sum here:

Intent of Generation

Below, please select the intent of generation from the following choices: Offset Load (unit will operate in parallel, but WILL NOT export power); Net Meter (unit will operate in parallel, but WILL export power); Wholesale Market Transaction, or Back-Up Generation.
*Intent of Generation:

My below signature confirms that I am the owner of the property where the solar application is installed and accept responsibility for the accuracy of the above information. I have read GreyStone's Distributed Generation Policy. I also understand that the proper installation and performance of the solar application is the sole responsibility of me, the installing contractors, and the equipment manufacturers.

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Signature

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Name:

Date: