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SCHEDULE 3 - DISTRIBUTED ENERGY RESOURCES INTERCONNECTION PROCESS <br />Certification of Completion <br />The Interconnection Customer should complete the Distributed Energy Resource Certification of <br />Completion for a proposed DER interconnection in the Simplified Process Track. As a condition of <br />interconnection, a completed copy of this form must be returned to the Utility. <br />Distributed Energy Resource Information <br />Interconnection Customer: <br />DER Project Address: <br />City: State: Zip Code: <br />Application ID: Meter Number: <br /> Yes No (If no please completed <br />Is the DER system owner-installed? <br />Installer Information) <br />Installer Information <br />Contact Name: <br />Name of Business: <br />Email: Phone: <br />Electrician Name License # <br />Electrical Permitting Authority <br />ŷĻ 59w ŷğƭ ĬĻĻƓ źƓƭƷğƌƌĻķ ğƓķ źƓƭƦĻĭƷĻķ źƓ ĭƚƒƦƌźğƓĭĻ ǞźƷŷ ƷŷĻ ƌƚĭğƌ ĻƌĻĭƷƩźĭğƌ ƦĻƩƒźƷƷźƓŭ ğǒƷŷƚƩźƷǤ ğƭ ǝĻƩźŅźĻķ <br />ĬǤ ƷŷĻ ƭźŭƓğƷǒƩĻ ĬĻƌƚǞ ƚƩ ƷŷĻ ğķķźƷźƚƓğƌƌǤ ğƷƷğĭŷĻķ ķƚĭǒƒĻƓƷ͵ <br />Inspector Signature: Date: <br />Inspector Name: Authority Having Jurisdiction (city/county)ʹ <br />***Please print clearly or type and return completed along with any additional documentation*** <br />For Office Use Only <br />Date Received: <br />ELK RIVER MUNICIPAL UTILITIES 1 <br /> <br />328 <br />