Special connection request Service and Installation Rules Appendix A11
Enquiries: 02 6293 5749
Fax: 02 6293 5750
All systems must be approved by ActewAGL and all relevant authorities prior to connection to the ActewAGL network. Systems must comply with the ActewAGL Service and Installation Rules, ActewAGL Electricity Connection Distribution Standard Customer Contract, ActewAGL Renewable Energy Generator Connection Contract and ActewAGL Guidelines for Grid Connected Photovoltaic Installations. All charges are as per the ActewAGL Schedule of Electricity Network Charges, as published by ActewAGL and available at wwwactewagl.com.au
Work site address 4Customer or business name 4Unit number
4Floor number
4Street number
4Street name 4Block
4Section
4Suburb
4State
4Postcode
System information 4System nominal output
Watts
Inverter details 4Manufacturer 4Model number
4DC Voltage
4AC Power
Panel details 4Manufacturer 4Model number
Single line diagram of system filled out? Yes
See back of page.
Installer information 4Contractor/Installer 4Business name
4Licence number 4BSCE accreditation number
Customer declaration By signing below I declare and agree that: the information I have provided in this form is accurate and correct. If for any reason this information is incorrect, I will submit a new Special connection request form for approval by ActewAGL I have read, understood, and accept the terms and conditions of the ActewAGL Renewable Energy Generator Connection Contract.
4Customer name
4Signature
4Date
/
/
Are you eligible to apply for the Electricity Feed-in Renewable Energy Generation scheme? Contact the ACT Government at www.act.gov.au for information. To apply for the scheme, please contact your electricity supplier. Yes No
Office use only 4Received date 4Officer name
/
4Signature
4Date
/
/
This approval will cease 90 days from the issue date unless a test certificate of installation is received from the licensed electrician. ActewAGL Distribution ABN 76 670 568 688 a partnership of ACTEW Distribution Limited ABN 83 073 025 224 and Jemena Networks (ACT) Pty Ltd ABN 24 008 552 663.
CCA309_03
/
Solar system line diagram
4Notes
4Contractor details
4ActewAGL officer approval
4Date
/
/
ActewAGL Distribution ABN 76 670 568 688 a partnership of ACTEW Distribution Limited ABN 83 073 025 224 and Jemena Networks (ACT) Pty Ltd ABN 24 008 552 663.
CCA309_03
4Customer details