Ill. Admin. Code tit. 83, § 466.APPENDIX B
Certificate of Completion
(To be completed and returned to the EDC when installation is complete
and final electric inspector approval has been obtained[1])
Interconnection Customer Information
| Name: | ||||||||||||||
| Mailing Address: | ||||||||||||||
| City: | State: | Zip Code: | ||||||||||||
| Telephone (Daytime): | (Evening): | |||||||||||||
| Facsimile Number: | E-Mail Address: | |||||||||||||
| Installer | Check if owner-installed | |||||||||||||||
| Name: | ||||||||||||||||
| Mailing Address: | ||||||||||||||||
| City: | State: | Zip Code: | ||||||||||||||
| Telephone (Daytime): | (Evening): | |||||||||||||||
| Facsimile Number: | E-Mail Address: | |||||||||||||||
Final Electric Inspection and Interconnection Customer Signature
The distributed generation facility is complete and has been approved by the local electric inspector having jurisdiction. A signed copy of the electric inspector's form indicating final approval is attached. The interconnection customer acknowledges that it shall not operate the distributed generation facility until receipt of the final acceptance and approval by the EDC as provided below.
| Signed: | Date: | ||||||
| (Signature of interconnection customer) | |||||||
| Printed Name: | |||||||
Check if copy of signed electric inspection form is attached
Check if copy of as built documents is attached (projects larger than 25 kW only)
…………………………………………………………………………………………………… Acceptance and Final Approval for Interconnection (for EDC use only)
The interconnection agreement is approved and the distributed generation facility is approved for interconnected operation upon the signing and return of this Certificate of Completion by EDC:
| Electric Distribution Company waives Witness Test? (Initial) | Yes | (____) | No | (____) | |||||
| If not waived, date of successful Witness Test: | Passed: (Initial) | ||||||||
| EDC Signature: | Date: | ||||||||
| Printed Name: | Title: | ||||||||
(Source: Amended at 41 Ill. Reg. 862, effective January 20, 2017)