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Elk River – Energy City <br />Demonstration Project Information Form <br />Date: <br />Name of Project: <br />Company/Organization(s): <br />Address: <br />Contact Person: <br />Telephone Number: <br />E-mail: <br />Fax: <br />Sector (please check the appropriate): _ Agriculture _ Commercial _ Industrial <br />Institutional Residential <br />Brief description of the project and technology(ies) (attach any pertinent materials): <br />Energy Efficiency (please check all appropriate): _ Co- Generation _ Cooling <br />_Domestic Water Heating _ Energy Services _ Environmental Controls — Food <br />Preparation & Storage _ Fuel Cell _ Heating _ Heat Recovery _ Industrial & <br />Process Controls _ Insulation/Envelope _ Lighting _ Motors & Adjustable Speed <br />Drives _ Ventilation/Air Quality _ Water Conservation _ Windows <br />Renewable Energy (please check all appropriate): _ Biomass — Earth Sheltered <br />_ Geo- Source _ Hydro _ Methane —Photovoltaic _ Refuse - Derived Fuel <br />Solar Wind <br />Please check any appropriate: <br />—New project _ Existing project _ Retrofit <br />Date commenced: Date completed: <br />Project location: <br />Project cost (anticipated): <br />Expected or known results (ex. Measurements of air emissions, reduced water usage, energy <br />consumption reduction, etc.): <br />