Portfolio Energy Credit ApplicationCustomers under NRS 704.766 – 704.775(Net Metering) and Residential Producers

Page 1 of 2Revised: July 2015

∗ Please visit http://puc.nv.gov/Renewable_Energy/RPS/PEC_Trading_Program/ to ensure you are using the most current form.

∗ Applications may be submitted electronically ONLY if submitted as a single PDF document combined with the requiredattachments. If unable to do so, the signedform and attachments must be printed and mailed to:PUCN: Attn PEC Administrator; 1150 E. Williams St.; Carson City, NV 89701

Applicant(s) First and Last Name(s)

Telephone Number E-Mail Address

System Street Address

City State Zip

PO Box or Mailing Address, City, State, and Zip (if different from above)

Individual or company submitting form (if not submitted by the owner of the system):

Type of system: Solar Electric Solar Thermal Wind Other (explain):

Month/Day/Year system was completed:

If solar electric: Number of Modules: Watts per Module:

If solar water heating system: Thermal energy meter: Yes No

If any information in the application changes, the Applicant must notify the Commission and supplyupdated information within 30 days of the occurrence of the change.

Owners of systems funded in whole or in part by any rebate or incentive (i.e., Solar Generations) arenot eligible to receive renewable energy credits.

PEC credits will be issued from the date that the PUCN receives a fully completed and acceptableapplication.

_____________________________________________________________________

Application Pursuant to NAC 704.8921OATH

I, [name of signatory] ________________________________________________, on behalf of [name of applicant]__________________________________________ declare under penalties of perjury, that in such capacity, I amqualified and authorized to file and verify such application; that I have carefully examined all the statements andmatters contained in the application; and that all such statements made and matters set forth therein are true andcorrect to the best of my knowledge, information and belief. Declarant further states that the application is made ingood faith, with the intention of presenting evidence in support thereof in every particular. Declarant further declaresthat the applicant agrees to submit to the jurisdiction of the Public Utilities Commission of Nevada for the purpose ofparticipating in the renewable energy credit trading program. Furthermore, the declarant declares that the applicant’srenewable energy system has not been built with the benefit of any rebates, incentives (i.e., Solar Generations), or anyother discounts that have disqualified the applicant from receiving portfolio energy credits.

____________________________________ ____________________________________Signature of Applicant(s)

*If submitting this form electronically, please click the box below; mailed applications require a signature.

SIGNATURE CERTIFICATION FOR ELECTRONICALLY SUBMITTED APPLICATIONSYou are digitally signing this application for Portfolio Energy Credits. Your signature indicates that you haveentered accurate and complete information.

Page 2 of 2Revised: July 2015

∗ Please visit http://puc.nv.gov/Renewable_Energy/RPS/PEC_Trading_Program/to ensure you are using the most current form.

∗ Applications may be submitted electronically ONLY if submitted as a single PDF document combined with therequired attachments. If unable to do so, the signedform and attachments must be printed and mailed to:PUCN: Attn PEC Administrator; 1150 E. Williams St.; Carson City, NV 89701

PUCN Renewable Energy Facility - Additional System Details

All applications MUST include the final, as-built site plan. Applications received without the

final site plan will be rejected.

Photovoltaic Systems:

1. Does this system address have a photovoltaic system built with the benefit of an incentive (such as Solar

Generations)? Yes or No

2. Solar Module Manufacturer and Model: __________________________________________________

3. Inverter(s) [check one]: Central Inverter or Microinverter

4. Contractor: _________________________________________________________________________

5. Electric Utility Bi-Directional Meter Manufacturer and Serial Number:

___________________________________________________________________________________

6. Solar Production Meter: Manufacturer and Serial Number: orInverter -Based (Web-Based) Metering

Method (describe): __________________________________________________________________

7. Annual kWh Electric ConsumptionPrior to Renewable Energy System Installation: _______________

8. Azimuth: _____° Array Vertical Tilt: _____° # of Modules: _____ True or Magnetic

Azimuth: _____° Array Vertical Tilt: _____° # of Modules: _____ True or Magnetic

Azimuth: _____° Array Vertical Tilt: _____° # of Modules: _____ True or Magnetic

Azimuth: _____° Array Vertical Tilt: _____° # of Modules: _____ True or Magnetic

Azimuth: _____° Array Vertical Tilt: _____° # of Modules: _____ True or Magnetic

*Please use additional pages for more than five azimuths

9. If applicable:

a. Additional Racking Detail Vertical Tilt: ____________°

b. Additional Racking Detail Direction (i.e., SW, NE, etc.): ____________

c. If using axis tracking, how many axes? _____

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Solar Thermal Systems:

1. Use of Solar Thermal System: Domestic Hot Water Space Heating Spa or Pool Heating

2. Contractor: _________________________________________________________________________

3. Industrial Process (describe): ___________________________________________________________

4. Solar Collector: Quantity, Manufacturer, and Model No.: ____________________________________

5. Months per year that the solar thermal system is in use for space heating or pool heating: ____________

6. Solar Storage Tank Size: _______________________________________________________________

7. Backup Storage Tank Size: __________ and Type: Electric Natural Gas Propane

8. Solar Thermal Controller Manufacturer and Model No.: ______________________________________

9. BTU Performance Metering: Yes No Manufacturer: _________ Model No.: ____________