Major Customer Connections. Application to Connect Non Export Embedded Generation Unit

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1 Major Customer Connections Application to Connect Non Export Embedded Generation Unit Privacy Notice Ergon Energy is collecting information on this form for the purpose of assessing your Network Connection Services: Connection Enquiry. This may include the collection of your personal information. Your personal information will not be disclosed to any external third parties without your consent unless authorised or required by law. If you wish to apply for access to this information, or make a privacy complaint you may contact the Privacy Officer on or privacy@ergon.com.au. Ergon Energy s privacy policy may be viewed at ergon.com.au. If you have provided personal information of another individual, please ensure that you advise the person about this privacy statement.

2 When completed, please this application form and supporting documents to For information about the connection process, please see the Major Customer Embedded Generation Information Pack which can be found at Customer Details (the Legal Entity for contractual purposes) Company Name (as per ASIC registration) ACN (9 digits) Contact Name Phone Number ABN (11 digits) Role / Title Mobile Number SECTION A Postal Address Address Website Address Other information about company (ie. joint venture) Your Non-Export Embedded Generation Application Section B (below) assists us to process your enquiry efficiently and ensure the correct process is followed and applicable to the size and type of the connection. For any mini or micro embedded generation enquiries (< 30 kva), please refer to the New Connections & Alterations page on our website, or contact Ergon Energy on or solarteam@ergon.com.au Non-Export Embedded Generation New Generator Connection - Non-Export Generation via IES >30 kva If you require an agreement for a generation system via an Inverter Energy System and will not export into the electricity grid but will make a physical connection to Ergon Energy s Network (i.e. Solar PV) SECTION B New Non-Export Embedded Generation via rotating machine (non IES) >30 kva If you require an agreement for a generation system that is NOT connected via an Inverter Energy System and that will not export into the electricity grid but will make a physical connection to Ergon Energy s Network (i.e. diesel generator) Alteration to an existing non-export embedded generation system - If you require a modification to an existing contract, i.e. additional generation or increase to approved size. Version 3 April

3 Consultant Company or Trading As Name (as per ASIC registration) ACN/ABN Contact Name Role Title Address (we will use as the preferred method of contact unless otherwise advised) Website Postal Address Phone Number Mobile Number Authorised Agent (if you wish to have an agent act on your behalf, please complete the below section) SECTION C I/we, the Customer listed in Section A, authorise _ (Name), of (Company) to act as my/our agent in relation to this enquiry and the project described in Section E, including, without limitation: to provide information or advice to Ergon Energy in respect of the project; to receive information or advice from Ergon Energy in respect of the project; to receive any invoices in respect of Ergon Energy's fees associated with a review of this application if indicated in Section D; and to pay any such invoices. I/we acknowledge and agree that Ergon Energy is entitled to: rely on any information or advice provided by the abovementioned agent; provide any information or advice to the abovementioned agent; issue any invoices associated with a review of this application to the abovementioned agent if indicated in Section D; and receive payment of such invoices from the abovementioned agent, as if the abovementioned agent were the Customer listed in Section A, and in place of that Customer. Signature Date Witness Signature Name Position Witness Name Invoicing Details (Application Assessment Fee) Customer The invoice will be issued to the Customer regardless of the consultant authorisation Registered Business Name (as per ASIC): Consultant The invoice will be issued to the Consultant as per the consultant authorisation signed in Section C. Other please complete details below The invoice will be issued to the party nominated below. SECTION D ACN/ABN Phone Number Contact name Mobile Number Address Postal Address Version 3 April

4 Project/Site Details Project/Site Name PROJECT DETAILS Registered Plan Number and/or Lease No. Site Address Connection Point Location (GPS) Latitude: Longitude: National Metering Identifier (NMI) (Google Earth Pin Attachment, files or spatial data are also sufficient. ) Is there existing generation on site? (i.e. existing PV / Solar installation, diesel generator (export or non-export). If YES, please provide detailed below Yes No Export No Export Size of Existing Unit kw Total Authorised Size of Existing Unit kw SECTION E Type of Generation Unit(s) (i.e. IES, Rotating Machine) Total Site Capacity (inc all Embedded Generation) kw Additional Details on Location (i.e. restrictions, cultural heritage etc) Version 3 April

5 Combined Output Capacity of Inverters Panel Capacity EMBEDDED GENERATION VIA IES If you are connecting an non-export embedded generation unit via Rotating Machine, please disregard this section. Please note: The IES system shall meet or exceed all requirements specified in AS4777. The PV is to be balanced across all phases. Details of Protection System (i.e. model, compliance details of components of protection system - to compliment the Single Line Diagram (SLD) provided) Energy Production (estimated energy production KWh per annum) kwh per annum Operating Hours (i.e. 24hrs/7 days per week operation) Inverter Brand and Model Battery Storage Capacity (pk. kw) Battery Storage Capacity (Ah) Compliant with IEC62116:2014? Yes No Note that installations with inverters that are not compliant may require installation of other equipment. (IEC 62116:2014 provides a test procedure to evaluate the performance of islanding prevention measures used with utility-interconnected PV systems. This standard describes a guideline for testing the performance of automatic islanding prevention measures installed in or with single or multi-phase utility interactive PV inverters connected to the distribution network.) Information to be submitted with an > 30 kw Non Export via IES application Mandatory Documents listed below (1-5) must be submitted with this application; 1. Product/Technical Specification Sheet for Inverters clearly showing compliance with IEC62116 and AS Product/Technical Specification Sheet for Protection Devices (clearly displaying compliance with IEC60255 Series) 3. Product/Technical Specification Sheet Battery Storage systems 4. Detailed Electrical Single Line Diagram 5. Site Plan showing the precise location of the Generation and where battery storage systems are installed eg: Google Earth Snapshot The above technical specification documents are also used to confirm system elements are compliant to relevant industry codes and specifications. Please see Section 5 of the Standard for Connection of Embedded Generators in the Ergon Energy Distribution Network (STNW1165) for a list of supporting documents that may also be requested. Failure to provide this information with your application will result in your application not being processed until we receive all information required, only then will the application be deemed complete. Please be aware that Ergon Energy may request additional information to assist with the assessment of your individual connection. Should you have any concerns with providing the requested information, please contact the Major Customer Group via majorconnections@ergon.com.au Version 3 April

6 EMBEDDED GENERATION VIA ROTATING MACHINE If you are connecting an non-export embedded generation unit via IES, please disregard this section. System Type: (technology) System Rating: (kwh) Connection Voltage Details of Protection System (i.e. model, compliance details of components of protection system - to compliment the SLD provided) Energy Production (estimated energy production KWh per annum) kwh per annum Operating Hours (i.e. 24hrs/7 days per week operation) Make and Model Information to be submitted with > 30 kw Non Export Non IES application Attached Mandatory Documents listed below (1-3) must be submitted with this application: Detailed single line diagram (SLD) Technology specification sheet for any rotating device Site plan showing location of generation and connection point Please note you must clearly identify the design specifications of your protection systems. It is recommended in addition to your required detailed single line diagram is clear, your provide the technical specifications of protection equipment utilised. These technical specification documents are also used to confirm system elements are compliant to relevant industry codes and specifications. Failure to provide this information with your application will result in your application not being processed until we receive all requested information and the application is deemed complete. Please be aware that Ergon Energy may request additional information to assist with the assessment of your individual connection. Yes No Should you have any concerns with providing the requested information, please contact the Major Customer Group via majorconnections@ergon.com.au. Version 3 April