Utility Intertie with Battery Backup Information Form

Contact Information

*Name:
*Street Address:
*City:
*State:
   *Zip Code:
*Email:
*Perfered method of contact:
Phone
Email
Mail
*Home Phone:
Work Phone:

Site Information

Do you own your own home?
 Yes No
New Construction Renovation
Existing Vacation
 
Roof Material:
Standing Seam Asphalt
Slate Rubber Membrane
Wood Shingle
 
Is there a south facing roof space ?
Yes
No
Roof Orientation(W, SW, S, SE, E)
Roof Pitch 0°(Flat)to 60 °
Is ther any shading? This includes even small branches and objects.
Roof Age?
Ground Mount option? In th event that it is impossible to mount the collectors on the roof, is there any shade free area on the ground to mount pannels?
Yes
 No
 
In the event of a utility outage what critical loads would you like to remain powered? Examples: Kitchen lights, Refrigerator, Well Pump, Furnace Fan, etc.
Lighting:
Kitchen Bedroom
Living Room Other
 
Other Devices:
Refrigerator/Freezer Storage Freezer
Furnace Fan Heating Circulators
Well Pumps Outlets

Electrical Information
Utillity Company:
kWh Usage- On most utility bills there is information about past kWh
consumption. This is sometimes in the form of a graph, chart or listing of
last year's usage. Per month averages are best. This homework is
necessary for us to size your system, estimate production percentages
and for use in financial analyses.
Jan.
 Feb.
 Mar.
 Apr.
May.
 Jun.
 Jul.
 Aug.
Sep.
 Oct.
 Nov.
 Dec.
 
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