SMALL GENERATOR INTERCONNECTION REQUEST (Application Form)

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SMALL GENERATOR INTERCONNECTION REQUEST (Application Form) Attachment 2 Transmission Provider: Bluestem Electric Cooperative, Inc. Designated Contact Person: Kevin Heptig Address: P.O. Box 5, Wamego, Kansas 66547 Telephone Number: (785) 456-2212 Fax: (785) - 456-2003 E-Mail Address: kevinh@bluestemelectric.com An Interconnection Request is considered complete when it provides all applicable and correct information required below. Per SGIP section 1.5, documentation of site control must be submitted with the Interconnection Request. Preamble and Instructions An Interconnection Customer who requests an interconnection must submit this Interconnection Request by hand delivery, mail, e-mail, or fax to the Transmission Provider. Processing Fee or Deposit: If the Interconnection Request is submitted under the Fast Track Process, the non-refundable processing fee is $500. If the Interconnection Request is submitted under the Study Process, whether a new submission or an Interconnection Request that did not pass the Fast Track Process, the Interconnection Customer shall submit to the Transmission Provider an initial deposit of not to exceed $1,000 towards the cost of the feasibility study. The feasibility study would be performed by the Transmission Provider or the Transmission Provider s agent. Should the cost of the feasibility study exceed $1000.00 and/or additional studies are required, the Interconnection Customer will be responsible for the additional costs related to the feasibility study and/or the additional studies. Interconnection Customer Information Legal Name of the Interconnection Customer (or, if an individual, individual's name) Name: Contact Person: Mailing Address: Small Generator Interconnection Request - 1 -

City: State: Zip: Facility Location (if different from above): Telephone (Day): Telephone (Evening): Fax: E-Mail Address: Alternative Contact Information (if different from the Interconnection Customer) Contact Name: Title: Address: Telephone (Day): Telephone (Evening): Fax: E-Mail Address: Application is for: New Small Generating Facility Capacity addition to Existing Small Generating Facility If capacity addition to existing facility, please describe: Will the Small Generating Facility be used for any of the following? To Supply Power to the Interconnection Customer? Yes No To Supply Power to Others? Yes No For installations at locations with existing electric service to which the proposed Small Generating Facility will interconnect, provide: (Local Electric Service Provider*) (Existing Account Number*) [*To be provided by the Interconnection Customer if the local electric service provider is different from the Transmission Provider] Contact Name: Title: Address: Small Generator Interconnection Request - 2 -

Telephone (Day): Telephone (Evening): Fax: E-Mail Address: Requested Point of Interconnection: Interconnection Customer's Requested In-Service Date: Small Generating Facility Information Data apply only to the Small Generating Facility, not the Interconnection Facilities. Energy Source: Solar Wind Hydro Hydro Type (e.g. Run-of-River): Diesel Natural Gas Fuel Oil Other (state type) Prime Mover: Fuel Cell Recip Engine Gas Turb Steam Turb Microturbine PV Other Type of Generator: Synchronous Induction Inverter Generator Nameplate Rating: kw (Typical) Generator Nameplate kvar: Interconnection Customer or Customer-Site Load: kw (if none, so state) Typical Reactive Load (if known): Maximum Physical Export Capability Requested: kw List components of the Small Generating Facility equipment package that are currently certified: Equipment Type 1. 2. 3. 4. 5. Certifying Entity Is the prime mover compatible with the certified protective relay package? Yes No Generator (or solar collector) Manufacturer, Model Name & Number: Version Number: Nameplate Output Power Rating in kw: (Summer) (Winter) Nameplate Output Power Rating in kva: (Summer) (Winter) Individual Generator Power Factor Rated Power Factor: Leading: Lagging: Small Generator Interconnection Request - 3 -

Total Number of Generators in wind farm to be interconnected pursuant to this Interconnection Request: Elevation: Single phase Three phase Inverter Manufacturer, Model Name & Number (if used): List of adjustable set points for the protective equipment or software: Note: A completed Power Systems Load Flow data sheet must be supplied with the Interconnection Request. Small Generating Facility Characteristic Data (for inverter-based machines) Max design fault contribution current: Instantaneous or RMS? Harmonics Characteristics: Start-up requirements: Small Generating Facility Characteristic Data (for rotating machines) RPM Frequency: (*) Neutral Grounding Resistor (If Applicable): Synchronous Generators: Direct Axis Synchronous Reactance, Xd: P.U. Direct Axis Transient Reactance, X' d: P.U. Direct Axis Subtransient Reactance, X" d: P.U. Negative Sequence Reactance, X 2: P.U. Zero Sequence Reactance, X 0: P.U. KVA Base: Field Volts: Field Amperes: Induction Generators: Motoring Power (kw): I 22 t or K (Heating Time Constant): Rotor Resistance, Rr: Stator Resistance, Rs: Stator Reactance, Xs: Rotor Reactance, Xr: Magnetizing Reactance, Xm: Short Circuit Reactance, Xd'': Small Generator Interconnection Request - 4 -

Exciting Current: Temperature Rise: Frame Size: Design Letter: Reactive Power Required In Vars (No Load): Reactive Power Required In Vars (Full Load): Total Rotating Inertia, H: Per Unit on kva Base Note: Please contact the Transmission Provider prior to submitting the Interconnection Request to determine if the specified information above is required. Excitation and Governor System Data for Synchronous Generators Only Provide appropriate IEEE model block diagram of excitation system, governor 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 the manufacturer's block diagram may not be substituted. Interconnection Facilities Information Will a transformer be used between the generator and the point of common coupling? Yes No Will the transformer be provided by the Interconnection Customer? Yes No Transformer Data (If Applicable, for Interconnection Customer-Owned Transformer): Is the transformer: single phase three phase? Transformer Impedance: % on kva Base Size: kva If Three Phase: Transformer Primary: Volts Delta Wye Wye Grounded Transformer Secondary: Volts Delta Wye Wye Grounded Transformer Tertiary: Volts Delta Wye Wye Grounded Transformer Fuse Data (If Applicable, for Interconnection Customer-Owned Fuse): (Attach copy of fuse manufacturer's Minimum Melt and Total Clearing Time-Current Curves) Manufacturer: Type: Size: Speed: Interconnecting Circuit Breaker (if applicable): Manufacturer: Type: Load Rating (Amps): Interrupting Rating (Amps): Trip Speed (Cycles): Interconnection Protective Relays (If Applicable): If Microprocessor-Controlled: Small Generator Interconnection Request - 5 -

List of Functions and Adjustable Setpoints for the protective equipment or software: Setpoint Function Minimum Maximum 1. 2. 3. 4. 5. 6. If Discrete Components: (Enclose Copy of any Proposed Time-Overcurrent Coordination Curves) Manufacturer: Type: Style/Catalog No.: Proposed Setting: Manufacturer: Type: Style/Catalog No.: Proposed Setting: Manufacturer: Type: Style/Catalog No.: Proposed Setting: Manufacturer: Type: Style/Catalog No.: Proposed Setting: Manufacturer: Type: Style/Catalog No.: Proposed Setting: Current Transformer Data (If Applicable): (Enclose Copy of Manufacturer's Excitation and Ratio Correction Curves) Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: Potential Transformer Data (If Applicable): Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: General Information Small Generator Interconnection Request - 6 -

Enclose copy of site electrical one-line diagram showing the configuration of all Small Generating Facility equipment, current and potential circuits, and protection and control schemes. This one-line diagram must be signed and stamped by a licensed Professional Engineer if the Small Generating Facility is larger than 50 kw. Is One-Line Diagram Enclosed? Yes No Enclose copy of any site documentation that indicates the precise physical location of the proposed Small Generating Facility (e.g., USGS topographic map or other diagram or documentation). Proposed location of protective interface equipment on property (include address if different from the Interconnection Customer's address) Enclose copy of any site documentation that describes and details the operation of the protection and control schemes. Is Available Documentation Enclosed? Yes No Enclose copies of schematic drawings for all protection and control circuits, relay current circuits, relay potential circuits, and alarm/monitoring circuits (if applicable). Are Schematic Drawings Enclosed? Yes No Applicant Signature I hereby certify that, to the best of my knowledge, all the information provided in this Interconnection Request is true and correct. For Interconnection Customer: Date: Small Generator Interconnection Request - 7 -

Attachment 3 Certification Codes and Standards IEEE1547 Standard for Interconnecting Distributed Resources with Electric Power Systems (including use of IEEE 1547.1 testing protocols to establish conformity) UL 1741 Inverters, Converters, and Controllers for Use in Independent Power Systems IEEE Std 929-2000 IEEE Recommended Practice for Utility Interface of Photovoltaic (PV) Systems NFPA 70 (2002), National Electrical Code IEEE Std C37.90.1-1989 (R1994), IEEE Standard Surge Withstand Capability (SWC) Tests for Protective Relays and Relay Systems IEEE Std C37.90.2 (1995), IEEE Standard Withstand Capability of Relay Systems to Radiated Electromagnetic Interference from Transceivers IEEE Std C37.108-1989 (R2002), IEEE Guide for the Protection of Network Transformers IEEE Std C57.12.44-2000, IEEE Standard Requirements for Secondary Network Protectors IEEE Std C62.41.2-2002, IEEE Recommended Practice on Characterization of Surges in Low Voltage (1000V and Less) AC Power Circuits IEEE Std C62.45-1992 (R2002), IEEE Recommended Practice on Surge Testing for Equipment Connected to Low-Voltage (1000V and Less) AC Power Circuits ANSI C84.1-1995 Electric Power Systems and Equipment Voltage Ratings (60 Hertz) IEEE Std 100-2000, IEEE Standard Dictionary of Electrical and Electronic Terms NEMA MG 1-1998, Motors and Small Resources, Revision 3 IEEE Std 519-1992, IEEE Recommended Practices and Requirements for Harmonic Control in Electrical Power Systems NEMA MG 1-2003 (Rev 2004), Motors and Generators, Revision 1 Small Generator Certification Codes and Standards - 1 -

Certification of Small Generator Equipment Packages Attachment 4 1.0 Small Generating Facility equipment proposed for use separately or packaged with other equipment in an interconnection system shall be considered certified for interconnected operation if (1) it has been tested in accordance with industry standards for continuous utility interactive operation in compliance with the appropriate codes and standards referenced below by any Nationally Recognized Testing Laboratory (NRTL) recognized by the United States Occupational Safety and Health Administration to test and certify interconnection equipment pursuant to the relevant codes and standards listed in SGIP Attachment 3, (2) it has been labeled and is publicly listed by such NRTL at the time of the interconnection application, and (3) such NRTL makes readily available for verification all test standards and procedures it utilized in performing such equipment certification, and, with consumer approval, the test data itself. The NRTL may make such information available on its website and by encouraging such information to be included in the manufacturer s literature accompanying the equipment. 2.0 The Interconnection Customer must verify that the intended use of the equipment falls within the use or uses for which the equipment was tested, labeled, and listed by the NRTL. 3.0 Certified equipment shall not require further type-test review, testing, or additional equipment to meet the requirements of this interconnection procedure; however, nothing herein shall preclude the need for an on-site commissioning test by the parties to the interconnection nor follow-up production testing by the NRTL. 4.0 If the certified equipment package includes only interface components (switchgear, inverters, or other interface devices), then an Interconnection Customer must show that the generator or other electric source being utilized with the equipment package is compatible with the equipment package and is consistent with the testing and listing specified for this type of interconnection equipment. 5.0 Provided the generator or electric source, when combined with the equipment package, is within the range of capabilities for which it was tested by the NRTL, and does not violate the interface components' labeling and listing performed by the NRTL, no further design review, testing or additional equipment on the customer side of the point of common coupling shall be required to meet the requirements of this interconnection procedure. 6.0 An equipment package does not include equipment provided by the utility. Small Generator Certification Codes and Standards 2

7.0 Any equipment package approved and listed in a state by that state s regulatory body for interconnected operation in that state prior to the effective date of these small generator interconnection procedures shall be considered certified under these procedures for use in that state. Small Generator Certification Codes and Standards 3