Interconnection Application

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Interconnection Application Member interested in applying for the interconnection of a distributed energy resource to the Utility s distribution system through the Fast Track or Study Processes are to fill out this Interconnection Application. The Interconnection Application is to be filled out completely by the applicant or as noted in each section of the application. The Utility will contact the applicant within 10 business days once the Interconnection Application and the corresponding processing fee is submitted to the Utility. The Utility will then notify the applicant of the completeness of their application. If the application is deemed incomplete by the Utility, the Utility will provide the applicant with a list of missing material. The applicant will then have 10 business days to provide the Utility with this information or request an extension, otherwise the application will be deemed incomplete and the applicant will lose their place in the queue. Sections that are noted with * are required to be filled out. Checklist for Submission to Utility The items below shall be included with submittal of the Interconnection Application to the Utility. Failure to include all items will deem the Interconnection Application incomplete. Non-Refundable Processing Fee Fast Track $100 + $1/kW for Certified Systems $100 + $2/kW for Non-Certified Systems Study Process $1,000 + $2/kW down payment. Additional study fees may apply. One-line diagram This one-line diagram must be signed and stamped by a Professional Engineer licensed in Minnesota if the DER is uncertified greater than 20 kw AC or if certified system is over 250 kw. Details required on one-line diagram specified at the end of the interconnection application. Schematic drawings for all protection and control circuits, relay current circuits, relay potential circuits, and alarm/monitoring circuits Inverter Specification Sheet(s) (if applicable) Documentation that describes and details the operation of protection and control schemes Documentation showing site control Included Aerial map showing DER system layout including major roadways and true north Possible Additional Documentation If the DER export capacity is limited, include information material explaining the limiting capabilities. If Energy Storage is included with the proposed DER system include the Energy Storage Application. Interconnection Application - February 2019 1

General * Select Review Process: Fast Track Process Study Process New Distribution Energy Capacity Addition or Material Modification Application is for: Resource to Existing Distributed Energy Resource If Capacity Addition or Material Modification to existing facility, please describe: Distributed Energy Resource will be used for what reason? (Check all that apply): Net Metering Supply Power to Interconnection Member Supply Power to Area EPS Installed DER System Cost (before incentives): $ Interconnection Member * Full Name (must match the name of the existing service account): Account Number: Meter Number: Mailing Address: City: State: Zip Code: Email: Phone: * Indicates section must be completed. Interconnection Application - February 2019 2

Application Agent * Is the Member using an Application Agent for this application? No If Interconnection Member is not using an Application Agent, please skip to the next section. Application Agent: Company Name: Email: Phone: Distributed Energy Resource Information * Estimated Installation Date: Location (if different from mailing address of Interconnection Member): Will the Proposed DER system be interconnected to an existing electric service? No Is the Distributed Energy Resource a single generating unit or multiple? Single Multiple DER Type (Check all that apply): Solar Photovoltaic Wind Energy Storage Combined Heat and Power Solar Thermal Other (please specify) DER systems with Energy Storage must also submit the Energy Storage Application to the Utility. Total Number of Distributed Energy Resources to be interconnected pursuant to this Interconnection Application: Phase configuration of Distributed Energy Resource(s): Single Phase Three Phase Type of Generator: Inverter Synchronous Induction Aggregate DER Capacity (the sum of nameplate capacity of all generation and storage devices at the PCC): kwac kvaac * Indicates section must be completed. Interconnection Application - February 2019 3

Export Capacity Limitation * Is the export capability of the DER limited? No If the DER export capacity is limited, complete the following sections and include information material explaining the limiting capabilities. Maximum Physical Export Capacity Requested: kwac If Yes, please provide additional details describing method of export limitation: Load Information * Interconnection Member s or Member-sited Load: kwac Typical Reactive Load (if known): Equipment Certification * Is the DER equipment certified? No 1 2 3 4 Please list all IEEE 1547 certified equipment below. Include all certified equipment manufacturer specification sheets with the Interconnection Application submission. Equipment Type Certifying Entity * Indicates section must be completed. Interconnection Application - February 2019 4

Prime Mover * Please indicate the prime mover: Solar Photovoltaic Microturbine Fuel Cell Reciprocating Engine Gas Turbine Other (please specify) Is the prime mover compatible with certified protection equipment package? No DER Manufacturer: Model Name & Number: Version: List of Adjustable Set Points for Protection Equipment or Software: Summer Name Plate Rating: kwac Summer Name Plate Rating: kwac Winter Name Plate Rating: kvaac Winter Name Plate Rating: kvaac Rated Power Factor: Leading: Lagging: A completed Power System Load Flow data sheet must be supplied with the Interconnection Application. Only appropriate sections beyond this point until the signature page are to be completed. Distributed Energy Resource Characteristic Data (for Inverter-based machines) Max design fault contribution current: Is your response to the previous field an Instantaneous or RMS measurement? Harmonic Characteristics: Instantaneous RMS Start-up Requirements: * Indicates section must be completed. Interconnection Application - February 2019 5

Distributed Energy Resource Characteristic Data (for Synchronous machines) RPM Frequency: Neutral Grounding Resistor: Direct Axis Synchronous Reactance, X d : Zero Sequence Reactance, X 0 : Direct Axis Transient Reactance, X d : Direct Axis Subtransient Reactance, X d : Negative Sequence Reactance, X 2 : KVA Base: Field Volts: Field Amperes: Please provide the appropriate IEEE model block diagram of excitation system, governing 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 submitted. Distributed Energy Resource Characteristic Data (for Induction machines) RPM Frequency: Motoring Power (kw): Heating Time Constant: Rotor Resistance, R r : Stator Resistance, R s : Stator Reactance, X s : Rotor Reactance, X r : Neutral Grounding Resistor: Exciting Current: Temperature Rise: Frame Size: Design Letter: Reactive Power Required In Vars (No Load): Reactive Power Required In Vars (Full Load): Magnetizing Reactance, X m : Total Rotating Inertia, H: Short Circuit Reactance, X d : Interconnection Application - February 2019 6

Interconnection Facilities Information Will a transformer be used between the DER and the Point of Common Coupling? Will the transformer be provided by the Interconnection Member? If yes, please fill in the fields below. Proposed location of protective interface equipment on property: No No Transformer Data (For Interconnection Member-Owned Transformer) What is the phase configuration of the transformer? Size (kva): Transformer Impedance (%): On kva Base: Transformer Volts: (Primary) Transformer Volts: (Secondary) Transformer Volts: (Tertiary) Single Phase Three Phase Delta: Wye: Wye Grounded: Delta: Wye: Wye Grounded: Delta: Wye: Wye Grounded: Transformer Fuse Data (For Interconnection Member-Owned Fuse) Manufacturer: Type: Size: Speed: Interconnecting Circuit Breaker (For Interconnection Member-Owned Circuit Breaker) Manufacturer: Type: Load Rating (in Amps): Interrupting Rating (In Amps): Trip Speed (Cycles): Interconnection Protective Relays (For Microprocessor Controlled Relays) Setpoint Function Minimum Maximum Interconnection Application - February 2019 7

Interconnection Protective Relays (For Relays with Discrete Components) 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: Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: Potential Transformer Data: Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: Manufacturer: Type: Accuracy Class: Proposed Ratio Connection: For Office Use Only Application ID: Date Received: Application Fee Received: No Date Completed: Interconnection Application - February 2019 8

Interconnection Agreement * Propose DER interconnections that are also deemed Qualifying Facilities less than 40 kw AC under Minnesota Statute 216B.164 are eligible to sign the Utility s Uniform Contract for Cogeneration and Small Power Production Facilities. Included in this agreement are payment terms for excess power generated by the proposed DER system the Utility may purchase. In lieu of the Utility s Uniform Contract for Cogeneration and Small Power Production Facilities, the Interconnection Member may choose to instead sign the Utility s Distribution Interconnection Agreement. The Interconnection Member requests an Interconnection Agreement to be executed in lieu of the Utility s Uniform Contract for Cogeneration and Small Power Production Facilities. No Disclaimers Must be completed by Interconnection Member * The Interconnection Member has opportunities to request a timeline extension during the interconnection process. Failure by the Interconnection Member to meet or request an extension for a timeline outlined in the Interconnection Process could result in a withdrawn queue position and the need to re-apply. Propose DER interconnection to the Utility s distribution submitted under the Fast Track Process may be moved into the Study Process if engineering screens are failed during the Interconnection Application review. Initials Application Signature Must be completed by Interconnection Member * I designate the individual or company listed as my Application Agent to serve as my agent for the purpose of coordinating with the Area EPS Operators on my behalf throughout the interconnection process. Initials I hereby certify that, to the best of my knowledge, the information provided in this Application is true, and that I have appropriate Site Control in conformance with the Interconnection Process. I agree to abide by the Terms and Conditions of the Interconnection Process and will inform the Utility if the proposed DER system changes from the details listed in this Interconnection Application. Applicant Signature: Date: ***Please print clearly or type and return completed along with any additional documentation*** Interconnection Application - February 2019 9

Information Required on One-Line Diagram An Interconnection Application must include a site electrical one-line diagram showing the configuration of all Distributed Energy Resource equipment, current and potential circuits, and protection and control schemes. The one-line diagram shall include: Applicant name. Application ID. Installer name and contact information. Address where DER system will be installed - must match application address. Be sure to list the address for the protective interface equipment if the protective interface equipment is located at a different address than the DER system. Correct positions of all equipment, including but not limited to panels, inverter, and DC/AC disconnect. Include distances between equipment, and any labeling found on equipment. This one-line diagram must be signed and stamped by a Minnesota licensed Professional Engineer if the Distributed Energy Resource is larger than 20 kw (if uncertified) and 250 kw (if certified.) Interconnection Application - February 2019 10