SAMPLE Please review the attached screening memo for customer requirements, system modifications, or special operating requirements for your generation system. After reviewing the screening memo, please also find the attached Interconnection Service Agreement (Exhibit F) for your use. Other forms are available at https://www.nationalgridus.com/masselectric/business/energyeff/4_standard-interconnection.asp. Please use the checklist below to ensure that you provide all necessary documentation: Legend: [ ] = Required; [C] = Complete; [NA] = Not Applicable; [NR] = Not Required 1. [ ] Please verify that the legal information, as entered in the attached Interconnection Service Agreement, is correct. 2. [ ] Exhibit F - Interconnection Service Agreement - must be signed and emailed to National Grid (Note: initials are required on every page at the bottom). 3. [ ] Exhibit G - Agreement between the Company and the Company's Retail Customer (if applicable) - must be signed and emailed to National Grid (Note: initials are required on every page at the bottom). 4. [ ] Schedule Z - must be signed and emailed to National Grid. 5. [ ] MA System of Assurance of Net Metering Eligibility documentation (if applicable). 6. [ ] The Certificate of Completion, signed by the local wiring inspector or an electric permit signed by the local wiring inspector must be emailed to National Grid. 7. [ ] Final relay settings, breaker(s) setting (curve) and testing plan. The testing plan shall include the testing company letter-head, be in a suitable format to be used by National Grid, in the field, to witness the test and should include the testing steps in chronological order. Each step should have a pass/fail field, a description of the action(s) required field and a description of the anticipated result field. 8. [ ] National Grid reserves the right to schedule a Witness Test upon receiving a Certificate of Completion, final relay settings and testing plan. National Grid anticipates one site visit per interconnection application. If more are required there will be an additional fee for each visit. 9. [ ] The customer will have to pay for the witness test by check. A check for X dollars should be sent to the address listed below after the witness test procedure is approved and before the witness test is conducted. 10. [ ] The customer must demonstrate that the system has passed a commissioning test, to be conducted by the contractor. a. [ ] National Grid must receive a signed memo attesting to the following: i. The system passed the "2 seconds shutdown when utility disconnect is open” test ii. The system passed the “5 minutes before restart after utility disconnect is closed" test iii. A visual inspection of the system confirms that the system matches the one line diagram iv. The relay settings identified in the Interconnection Standards are adhered to and listed in the signed memo. b. [ ] A complete AS BUILT 1-line diagram must be provided. The 1-line and the Memo should be signed and dated on the day of the inspection. 11. [ ] The customer must provide clear pictures of the following, in close up and wide angle format. a. [ ] The utility revenue meter i. [ ] If a phone line is required, this picture must show the phone line. b. [ ] The generator(s) or inverter(s) c. [ ] The EXTERNAL AC Utility Disconnect Switch d. [ ] The current limiting device (fuse or circuit breaker) e. [ ] The customer owned production meter (if installed) SAMPLE SAMPLE f. [ ] The PCC (Point of Common Coupling, as identified in the Interconnection Service Agreement) 12. [ ] Permanent Plaques (visible at eye level), as described below (Pictures must clearly and legibly show the lettering on the plaques). a. [ ] A permanent plaque on the external AC Utility Disconnect Switch labeled “AC Utility Disconnect Switch”. b. [ ] A permanent plaque or directory shall be installed at the utility revenue meter with a warning about the generator(s) installed. i. [ ] If the external utility disconnect switch is not adjacent to the utility revenue meter, an additional permanent plaque shall be provided at the utility revenue meter and the PCC locating the switch. c. [ ] A permanent plaque or directory shall be installed at the PCC with a warning about the generator(s) installed. i. [ ] If the PCC is at a pad mounted transformer, the plaque must be on the right door of the transformer. ii. [ ] If the PCC is at the weatherhead or is the revenue meter socket, the plaque at Utility Revenue Meter is sufficient. iii. [ ] If the PCC is at a primary meter, the plaque must be on the pole where the primary meter is mounted. iv. [ ] If the external utility disconnect switch is not adjacent to PCC, an additional permanent plaque shall be provided at the PCC locating the switch. d. [ ] A permanent plaque on the Customer-owned production meter labeled “Customer-Owned Production Meter”. e. [ ] If the new service equipment for the generator and all existing service equipment are not grouped and adjacent, a permanent plaque shall be provided at each piece of service equipment locating all other pieces of service equipment. f. [ ] All plaques as described in NEC 705.10, 705.12 (7), 690.56, 692.4 and 705.70 shall be installed when applicable. 13. [ ] The customer is responsible for providing National Grid with evidence of insurance in compliance with section 11 of the agreement and the Interconnection Standards. Please provide an original insurance certificate naming "National Grid USA and its Subsidiaries & Affiliates" as additional insured. The original must be mailed to the address in the service agreement. 14. [ ] Phone line installed and phone number provided. Phone number: . 15. [ ] QF certificate documentation (FERC Form No. 556). 16. [ ] Information as required in the Impact Study. 17. [ ] Information as required in the Customer Requirements section of the Screening Memo. 18. [ ] Installation of Net Meter. (Note: Net meter installation could take up to three weeks for installation after documentation and phone line provided.) 19. [ ] Authority to Interconnect Letter to be provided by National Grid after all requirements satisfied, and after net meter has been set. The National Grid’s Electric System Bulletin ESB756 “Requirements for Parallel Generation Connected to a National Grid-Owned EPS” applies to this distributed generation system. In Massachusetts, Appendix C of ESB756 should be referenced for all distributed generation projects that operate in parallel with National Grid’s EPS. ESB756C is available at: www.nationalgridus.com/non_html/shared_constr_esb756.pdf. SAMPLE