Commercial Geothermal Program

Transcription

1 PF2956V(4) Rev FORM C Completion Declaration Instructions: 1. Complete this form once the geothermal heat pump system is installed and operational. 2. Mail this form along with the completed Completion Questionnaire (Form D), Installed Equipment Summary (Form E), and Project System Design Summary (Form F), along with a copy of project invoice(s), Start-up Veriمحcation and Manufacturer Test Data Sheets, Certiمحcate of Electrical Approval, Occupancy Certiمحcate (if applicable), and Licence to Use Water for Heating/Cooling Purposes from Manitoba Water Stewardship (if applicable) to Manitoba Hydro s, 360 Portage Ave. (7), Winnipeg, MB R3C 0G8. Call for further assistance. Note: Manitoba Hydro will not issue the Incentive cheque unless all the above information is received. Failure to do so will prevent payment. Customer information Business name Manitoba Hydro account no. Electrical permit no. Mailing address CITY/TOWN PROVINCE POSTAL CODE Building permit no. Manitoba Water Stewardship - Water Use license no.(attach copy of the completed license) Customer statement I, the Customer, declare that the Equipment, for which an Incentive is being applied for, has been fully installed and is operational. I declare that all terms and conditions of the Agreement set forth by Manitoba Hydro have been, and will be, complied with. I authorize Manitoba Hydro to release the final approved System Installation Incentive to the person named in the CHEQUE PAYMENT INFORMATION bo below. Signed by (Customer) Print name Print title Assignment (Only if Incentive assigned) I, the Customer, do hereby irrevocable direct and authorize Manitoba Hydro to pay the incentive to the Design Consultant, Contractor/Installer named in the bo titled CHEQUE PAYMENT INFORMATION. Signed by (Customer) Cheque payment information Payee name Cheque mailing address CITY/TOWN PROVINCE POSTAL CODE MANITOBA HYDRO USE ONLY Post-inspected and approved for payment by (Regional Representative) Representative name FINAL APPROVED SYSTEM INSTALLATION INCENTIVE AMOUNT Region Did the installed on-site equipment inventory match the Installed Equipment Summary (Form E) submitted by the customer? Yes No (If No, comment on the discrepancies) Application verified by (Customer Engineering Services) Payment authorized by (Program Coordinator) Approved by (Department Manager) RECEIVED METER TAG NO(S). Disbursements Cheque no. Incentive breakdown Net Amt GST Cost element Cheque amount Cheque delivery instruction (Refer to P95 for cheque delivery code) Cheque delivery code Name Order no Activity code 0010 Due date Amount DISTRIBUTION: WHITE Manitoba Hydro YELLOW Customer

2 PF2956V(5) Rev Completion Questionnaire FORM D The following questions are for program evaluation purposes only. Your answers do not affect the Incentive you are eligible for under Manitoba Hydro s Commercial Geothermal Program. You must complete all questions before Incentive is processed. Note: Check only one answer unless otherwise speciمحed. Section A Program information A1. If Manitoba Hydro s had not eisted, what type of equipment would have been installed? Less energy efمحcient HVAC equipment The same geothermal heat pump system that was just installed Would not have replaced eisting system Do not know Other: (specify) A2. What is the primary reason for replacing your current heating/cooling system? Incentive (rebate) Improve system performance Energy savings Improve comfort Reduce environmental impact Other: (specify) A3. To what degree, if any, did the following affect your decision to install energy efمحcient heat pump? Strongly affected Somewhat affected Did not affect Do not know N/A Contractor/Installer Designer/Engineer/Consultant Manitoba Hydro A4. On a 9-point scale, with 1 being etremely dissatisمحed and 9 being etremely satisمحed, how satisمحed are you with the following? Amount of paperwork Compleity of application Timeliness of application approval Rebate amount Overall satisfaction with the Etremely dissatisمحed Etremely satisمحed Do not know Section B General information B1. How did you hear about the Power Smart for Business programs offered by Manitoba Hydro? (check all that apply) Manitoba Hydro/Power Smart representative Advertisement (brochure/print materials) Contractor/Installer Designer/Engineer/Consultant Manitoba Hydro website Other: (specify) Seminar/luncheon/trade show: (specify) B2. Are you planning other commercial renovations? (check all that apply) Space heating equipment Water heating equipment Ventilation Air conditioning/chiller Lighting Insulation Windows Commercial clothes washers Refrigeration Kitchen appliances Other: (specify) For more information on the above, visit or call Power Smart for Business at , or B3. If investing in energy efمحcient technology, what would be the maimum time allowed to recover your investment? 1 year or less 2 or 3 years 4 or 5 years 6 to 10 years Do not know Other: (specify) Section C General comments Add any comments or suggestions about Manitoba Hydro s. Thank you for your participation in Manitoba Hydro s!

3 PF2956V(6) Rev Installed Equipment Summary FORM E Instructions: The Project Installer/Engineer will complete the sections below for each type of geothermal heat pump installed. SYSTEM START-UP Unit type Manufacturer Model no. Quantity installed Per unit nominal cooling tons Per unit auiliary electric heat (kw) Motor size of ground loop or well pump (HP) HEATING OUTPUT * Unit type (from above) Manufacturer rated heating capacity (Btu/h) / unit Quantity installed Total heating capacity (per unit Btu/h Quantity Installed) TOTAL SYSTEM HEATING CAPACITY / 1000 Btu/h Unit type (from above) Manufacturer rated cooling capacity (Btu/h) / unit COOLING OUTPUT ** (if applicable) Quantity installed Total cooling capacity (per unit Btu/h Quantity Installed) TOTAL SYSTEM COOLING CAPACITY / 1000 Btu/h Units capacity based on CAN/CSA - C Standard rating test - Liquid entering heat echanger: * Unit heating 32 F EWT for closed loop ground heat echangers OR 50 F for open loop ground heat echangers. ** Unit cooling 77 F EWT for closed loop ground heat echangers OR 59 F for open loop ground heat echangers. Installed forced air (water-to-air) geothermal heat pump units must be certiمحed by CSA or ARI/ISO

4 PF2956V(7)/f Rev Project System Design Summary FORM F Instructions: The Project Installer/Engineer will complete this form to estimate the annual building loads, operational characteristics, system cost and ground heat echanger details. Note: Paid invoices and a copy of the completed Licence to Use Water for Heating/Cooling Purposes from Manitoba Water Stewardship (including a site plan showing the well locations), Dimensioned Loop Design/Site Plan Drawing (if applicable) must be submitted with this completed form. Building design heating/cooling loads Complete the tables below to outline the building s annual heating/cooling loads. Outdoor design temperature Indoor design temperature Average weekly hours building is occupied Geothermal sizing Percentage of design heat loss Percentage of annual heating energy Winter hrs/wk Summer hrs/wk % % DESIGN LOADS Building envelope transmission Inمحltration continuous (maimum 0.3 AC/H) Total Eligible Load Inمحltration intermittent Ventilation continuous Ventilation intermittent HEAT LOSS AT WINTER DESIGN TEMP. kw HEAT GAIN AT SUMMER DESIGN TEMP. kw Internal heat gain N/A N/A Solar heat gain N/A N/A Total Design Load System cost Total installed cost of geothermal heat pump system () Estimated cost for a base case electrical heating system () Open loop groundwater wells (if applicable) Total supply owمخ rate USGPM litres/sec. Total return owمخ rate USGPM litres/sec. Groundwater temperature F C Describe manual calculation methods or software used to size well system: Supply well no. 1 Supply well no. 2 Supply well no. 3 WATER FLOW RATE USGPM L/S WELL BORE DEPTH feet metres Return well no. 1 Return well no. 2 Return well no. 3 Licence to use water for heating/cooling purposes from Manitoba Water Stewardship License no. Water quality test completed Yes No (If Yes, attach a copy of the test report) Continued on reverse.

5 PF2956V(7)/r Closed loop ground heat echanger (if applicable) Attach dimensioned loop design/site plan drawing. Ground conditions obtained from Assumed table values If measured, describe test methods: Measured values Ground thermal conductivity (select unit) Speciمحc heat capacity (select unit) Describe ground conditions: Btu/h ft. F W/m K Btu/lb F kj/kg K Ground thermal diffusivity (select unit) Constant ground temperature (select unit) ft.²/day m²/day F C Vertical closed loop No. of boreholes Borehole grid pattern (e.g. 45) Depth of boreholes (select unit) Borehole pipe diameter (select unit) Borehole spacing (select unit) Grout material Grout conductivity (select unit) Btu/h ft. F W/m K Horizontal closed loop Select pipe conمحguration No. of trenches 2 pipe 4 pipe Slinky Other No. of pipes per trench Loop pipe diameter (select unit) Trench spacing (select unit) Pipe depth in trench (select unit) Total trench length (select unit) Total pipe length (select unit) Surface water - closed loop Select source Lake River Pond Loop pipe diameter (select unit) Total pipe length (select unit) Describe manual calculation methods or software used to size loop: Pipe conمحguration Slinky Other (specify) Submerged depth (select unit) Mechanical system designers declaration To the best of my knowledge, the designed mechanical system was designed and installed in accordance with all applicable municipal building codes, provincial and federal regulations, and installation standards. Name Title/Position Signature Company Phone no. Engineer: afمح seal, sign & date here (if applicable) Ground heat echanger designers declaration To the best of my knowledge, the well systems or closed loop ground heat echanger(s) were designed and installed in accordance with all applicable municipal building codes, provincial and federal regulations, and installation standards. Name Title/Position Signature Company Phone no. Engineer: afمح seal, sign & date here (if applicable)