**Section 9006 Simplified Application Small Wind Technical Worksheet**

(Total Project Costs of \$200,000 or less & turbines 100kW or smaller)

+-----------------------------------+-----------------------------------+
| **Applicant Information**         | **Document Checklist**            |
+-----------------------------------+-----------------------------------+
| First Name:                       | **Attach the following            |
|                                   | documentation:**                  |
| Middle Initial:                   |                                   |
|                                   | 1\. Describe project site.        |
| Last Name:                        | Preferably attach a one page      |
|                                   | color site map. Must indicate     |
| Zip Code:                         | location of wind turbines,        |
|                                   | structures or trees, inverter     |
| Company/Organization (if          | batteries (if any), lockable      |
| applicable):                      | disconnect switch, and point of   |
|                                   | connection with the utility       |
| Project Name:                     | system.......                     |
|                                   | ................................. |
|                                   |                                   |
|                                   | 2\. Annual average wind speed and |
|                                   | wind direction (documentation and |
|                                   | data                              |
|                                   | so                                |
|                                   | urce)..................\...\..... |
|                                   |                                   |
|                                   | 3\. Estimated annual energy       |
|                                   | output (attach documentation and  |
|                                   | meth                              |
|                                   | odology).....................\... |
|                                   |                                   |
|                                   | 4\. One-line diagram for          |
|                                   | electrical interconnection...     |
|                                   |                                   |
|                                   | 5\. Optional, but helpful, site   |
|                                   | photos. Preferred method is to    |
|                                   | take a series of photographs from |
|                                   | the proposed turbine location.    |
|                                   | Rotate 360 degrees clockwise      |
|                                   | taking pictures every 46 degrees. |
|                                   | Indicate predominate wind         |
|                                   | direction on one                  |
|                                   | photo\........                    |
|                                   | .\............................... |
+-----------------------------------+-----------------------------------+
| **Section a: Qualifications of    |                                   |
| key service providers.**          |                                   |
+-----------------------------------+-----------------------------------+
| Company/Organization Name:        |                                   |
|                                   |                                   |
| First Name:       Last Name:      |                                   |
|       Title:                      |                                   |
|                                   |                                   |
| Daytime Phone (include area       |                                   |
| code):       Web Site:            |                                   |
|                                   |                                   |
| Mailing Address:                  |                                   |
|                                   |                                   |
| City:       State:       Zip:     |                                   |
|                                   |                                   |
|                                   |                                   |
| Function:                         |                                   |
|                                   |                                   |
| Last manufacturer workshop        |                                   |
| attended:                         |                                   |
|                                   |                                   |
| Credentials and years of related  |                                   |
| experience:                       |                                   |
|                                   |                                   |
| Number and type of similar        |                                   |
| systems installed:                |                                   |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| Company/Organization Name:        |                                   |
|                                   |                                   |
| First Name:       Last Name:      |                                   |
|       Title:                      |                                   |
|                                   |                                   |
| Daytime Phone (include area       |                                   |
| code):       Web Site:            |                                   |
|                                   |                                   |
| Mailing Address:                  |                                   |
|                                   |                                   |
| City:       State:       Zip:     |                                   |
|                                   |                                   |
|                                   |                                   |
| Function:                         |                                   |
|                                   |                                   |
| Last manufacturer workshop        |                                   |
| attended:                         |                                   |
|                                   |                                   |
| Credentials and years of related  |                                   |
| experience:                       |                                   |
|                                   |                                   |
| Number and type of similar        |                                   |
| systems installed:                |                                   |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| Company/Organization Name:        |                                   |
|                                   |                                   |
| First Name:       Last Name:      |                                   |
|       Title:                      |                                   |
|                                   |                                   |
| Daytime Phone (include area       |                                   |
| code):       Web Site:            |                                   |
|                                   |                                   |
| Mailing Address:                  |                                   |
|                                   |                                   |
| City:       State:       Zip:     |                                   |
|                                   |                                   |
|                                   |                                   |
| Function:                         |                                   |
|                                   |                                   |
| Last manufacturer workshop        |                                   |
| attended:                         |                                   |
|                                   |                                   |
| Credentials and years of related  |                                   |
| experience:                       |                                   |
|                                   |                                   |
| Number and type of similar        |                                   |
| systems installed:                |                                   |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| **Section b: Agreements, permits, |                                   |
| and certifications.**             |                                   |
+-----------------------------------+-----------------------------------+
| **(1) Identify all required       |                                   |
| building agreements and           |                                   |
| permits:**                        |                                   |
+-----------------------------------+-----------------------------------+
| Building[     ]{.underline} have  |                                   |
| permit attached initiated needs   |                                   |
| to be sent none required          |                                   |
|                                   |                                   |
| Electrical[     ]{.underline}     |                                   |
| have permit attached initiated    |                                   |
| needs to be sent none required    |                                   |
|                                   |                                   |
| Zoning[     ]{.underline} have    |                                   |
| permit attached initiated needs   |                                   |
| to be sent none required          |                                   |
|                                   |                                   |
| Other[     ]{.underline} have     |                                   |
| permit attached initiated needs   |                                   |
| to be sent none required          |                                   |
+-----------------------------------+-----------------------------------+
| **(2) Interconnection agreements  |                                   |
| and tariff arrangements:**        |                                   |
+-----------------------------------+-----------------------------------+
| Interconnection                   |                                   |
| agreement...............completed |                                   |
| attached initiated needs to be    |                                   |
| sent none required                |                                   |
|                                   |                                   |
| Tariff                            |                                   |
| arrangement..                     |                                   |
| ........................completed |                                   |
| attached initiated needs to be    |                                   |
| sent none required                |                                   |
|                                   |                                   |
| Utility name:                     |                                   |
|                                   |                                   |
| Describe plans for meeting        |                                   |
| utility requirements, if          |                                   |
| applicable:                       |                                   |
+-----------------------------------+-----------------------------------+
| **(3) Environmental:**            |                                   |
+-----------------------------------+-----------------------------------+
| Are there any additional          |                                   |
| environmental concerns that are   |                                   |
| not previously identified on Form |                                   |
| RD 1940-20?                       |                                   |
|                                   |                                   |
| Yes No                            |                                   |
|                                   |                                   |
| If yes, describe:                 |                                   |
+-----------------------------------+-----------------------------------+
| **Section c: Resource             |                                   |
| assessment.**                     |                                   |
+-----------------------------------+-----------------------------------+
| Average annual wind speed:        |                                   |
| (mph or m/s) Height at reference  |                                   |
| point:       (m or ft)            |                                   |
|                                   |                                   |
| Wind direction:       Wind Speed: |                                   |
|       Elevation:                  |                                   |
|                                   |                                   |
| Estimated annual energy output\*: |                                   |
|       kWh                         |                                   |
|                                   |                                   |
| \*Please attach documentation and |                                   |
| methodology used for calculating  |                                   |
| estimated annual energy output.   |                                   |
+-----------------------------------+-----------------------------------+
| **Section d: Design and           |                                   |
| engineering.**                    |                                   |
+-----------------------------------+-----------------------------------+
| **Turbine:**                      |                                   |
+-----------------------------------+-----------------------------------+
| Wind turbine manufacturer:        |                                   |
|                                   |                                   |
| Manufacturer's web site address:  |                                   |
|                                   |                                   |
|                                   |                                   |
| Turbine Model:                    |                                   |
|                                   |                                   |
| Number of similar model turbines  |                                   |
| sold by manufacturer:             |                                   |
|                                   |                                   |
| Wind turbine rated power:         |                                   |
|                                   |                                   |
| Wind turbine peak power:          |                                   |
|                                   |                                   |
| Wind turbine output voltage:      |                                   |
|                                   |                                   |
|                                   |                                   |
| Number of turbines for this       |                                   |
| project:                          |                                   |
|                                   |                                   |
| Total wind system output:         |                                   |
| (No. of turbines x power output   |                                   |
| rating)                           |                                   |
|                                   |                                   |
| Turbine rotor diameter:           |                                   |
| (ft. or m)                        |                                   |
+-----------------------------------+-----------------------------------+
| **Tower:**                        |                                   |
+-----------------------------------+-----------------------------------+
| Tower height:       (ft. or m)    |                                   |
|                                   |                                   |
| Manufacturer Type: guide tilt up  |                                   |
| self supporting                   |                                   |
+-----------------------------------+-----------------------------------+
| **Inverter:**                     |                                   |
+-----------------------------------+-----------------------------------+
| Inverter manufacturer:            |                                   |
|                                   |                                   |
| Inverter model:                   |                                   |
|                                   |                                   |
| Number of inverters:              |                                   |
|                                   |                                   |
| Inverter's continuous AC rating:  |                                   |
|                                   |                                   |
|                                   |                                   |
| Total inverter output (Inverter   |                                   |
| continuous AC rating x number of  |                                   |
| inverters):                       |                                   |
+-----------------------------------+-----------------------------------+
| **Battery:**                      |                                   |
+-----------------------------------+-----------------------------------+
| Battery model:                    |                                   |
|                                   |                                   |
| Battery voltage:       Volts      |                                   |
|       Amp-hour rating (20 hour    |                                   |
| rate)                             |                                   |
|                                   |                                   |
| Number of strings:                |                                   |
|                                   |                                   |
| DC bus voltage:       Volts       |                                   |
|                                   |                                   |
| Turbine controller model (if      |                                   |
| applicable):                      |                                   |
|                                   |                                   |
| Diversion load power rating (if   |                                   |
| applicable):                      |                                   |
+-----------------------------------+-----------------------------------+
| **System type and mode of         |                                   |
| operation: (check applicable)**   |                                   |
+-----------------------------------+-----------------------------------+
| Utility interactive               |                                   |
| (parallel/capable of backfeeding  |                                   |
| the meter)                        |                                   |
|                                   |                                   |
| Utility interactive with battery  |                                   |
| backup (capable of backfeeding    |                                   |
| the meter)                        |                                   |
|                                   |                                   |
| Dedicated circuit, utility power  |                                   |
| as backup (transfer switch)       |                                   |
|                                   |                                   |
| Dedicated circuit, battery        |                                   |
| charging, utility power as backup |                                   |
| (transfer switch)                 |                                   |
|                                   |                                   |
| Stand-alone (system confined to   |                                   |
| an independent circuit, no        |                                   |
| utility backup)                   |                                   |
|                                   |                                   |
| Stand-alone with battery backup   |                                   |
| (system confined to an            |                                   |
| independent circuit, no utility   |                                   |
| backup)                           |                                   |
+-----------------------------------+-----------------------------------+
| **Section e: Project development  |                                   |
| schedule.**                       |                                   |
+-----------------------------------+-----------------------------------+
| Check boxes to indicate activity: |                                   |
|                                   |                                   |
|   -----                           |                                   |
| --------- ------- ------- ------- |                                   |
|   **Mo                            |                                   |
| nth**      **1 2 3 **5 6 7 **9 10 |                                   |
|                                   |                                   |
|           4**     8**     11 12** |                                   |
|                                   |                                   |
|                                   |                                   |
|                                   |                                   |
|   Approved                        |                                   |
|   permits &                       |                                   |
|   permits                         |                                   |
|                                   |                                   |
|                                   |                                   |
|                                   |                                   |
|   Equipment is                    |                                   |
|   ordered                         |                                   |
|                                   |                                   |
|                                   |                                   |
|                                   |                                   |
|   Equipment                       |                                   |
|   arrives                         |                                   |
|                                   |                                   |
|                                   |                                   |
|                                   |                                   |
|   Construction                    |                                   |
|                                   |                                   |
|                                   |                                   |
|                                   |                                   |
|   Startup and                     |                                   |
|   Shakedown                       |                                   |
|                                   |                                   |
|                                   |                                   |
|   -----                           |                                   |
| --------- ------- ------- ------- |                                   |
|                                   |                                   |
| What is the estimated start date? |                                   |
|                                   |                                   |
|                                   |                                   |
| Is the proposed equipment readily |                                   |
| available........................ |                                   |
| ..............................Yes |                                   |
| No                                |                                   |
|                                   |                                   |
| Do you anticipate any delays in   |                                   |
| receiving the equipment once it   |                                   |
| is ordered..............Yes No    |                                   |
|                                   |                                   |
| Describe the impact of any delays |                                   |
| on the project completion:        |                                   |
+-----------------------------------+-----------------------------------+
| **Section f: Project economic     |                                   |
| assessment.**                     |                                   |
+-----------------------------------+-----------------------------------+
| **Costs of project components:**  |                                   |
+-----------------------------------+-----------------------------------+
| T                                 |                                   |
| urbine........................... |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Tower...                          |                                   |
| ................................. |                                   |
| ................................. |                                   |
| ............\...\...\...\...\.... |                                   |
| \$                                |                                   |
|                                   |                                   |
| In                                |                                   |
| verter........................... |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Ba                                |                                   |
| tteries.......................... |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Pumps............................ |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Site                              |                                   |
| Preparation................       |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Foundation....................... |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Fee/Permits...................... |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| El                                |                                   |
| ectrician........................ |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Ins                               |                                   |
| taller........................... |                                   |
| ................................. |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Extended warranty (if             |                                   |
| appli                             |                                   |
| cable)........................... |                                   |
| ................................. |                                   |
| \$                                |                                   |
|                                   |                                   |
| Description:                      |                                   |
|                                   |                                   |
| Other project                     |                                   |
| cost......................        |                                   |
| ................................. |                                   |
| ..........................\$      |                                   |
|                                   |                                   |
| Description:                      |                                   |
|                                   |                                   |
| **Total eligible project cost:    |                                   |
| \$     **                         |                                   |
+-----------------------------------+-----------------------------------+
| **Financial performance and       |                                   |
| simple payback calculation**      |                                   |
+-----------------------------------+-----------------------------------+
| Calculate simple payback using    |                                   |
| estimated Annual Energy Output    |                                   |
| (kWh generated) from the project, |                                   |
| utility tariffs (for either net   |                                   |
| metering or net billing,          |                                   |
| whichever is applicable), and any |                                   |
| applicable production incentives. |                                   |
|                                   |                                   |
| *Simple payback calculation:*     |                                   |
|                                   |                                   |
| *Total Eligible Project Cost*     |                                   |
|                                   |                                   |
| *Simple Payback Period (in years) |                                   |
| =                                 |                                   |
| \-\-\-\-                          |                                   |
| \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\ |                                   |
| -\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--* |                                   |
|                                   |                                   |
| *Annual Savings/Income*           |                                   |
|                                   |                                   |
| *Where: Annual Savings/Income =*  |                                   |
|                                   |                                   |
| *(Estimated Annual Energy Output  |                                   |
| x Local Customer Rate)+ Value of  |                                   |
| Production Incentives*            |                                   |
|                                   |                                   |
| **EXAMPLE:**                      |                                   |
|                                   |                                   |
| Annual Savings/Income calculation |                                   |
| for Net Metering (single          |                                   |
| bi-directional meter) or Net      |                                   |
| Billing (two-directional Meters)  |                                   |
|                                   |                                   |
| Estimated Annual Energy Output    |                                   |
| (AEO) kWh:                        |                                   |
|                                   |                                   |
| Electricity consumed on site      |                                   |
|                                   |                                   |
| (utility bill reduction)          |                                   |
| [     ]{.underline}AEO kWh        |                                   |
| x[     ]{.underline}c/kWh =       |                                   |
| \$[     ]{.underline}             |                                   |
|                                   |                                   |
| (Local cost of electricity        |                                   |
| (customer retail rate)            |                                   |
|                                   |                                   |
| Net excess electricity            |                                   |
| [     ]{.underline}AEO kWh        |                                   |
| x[     ]{.underline}c/kWh =       |                                   |
| \$[     ]{.underline}             |                                   |
|                                   |                                   |
| Price paid by utility for net     |                                   |
| excess energy (net metering) or   |                                   |
|                                   |                                   |
| utility buy back rate (net        |                                   |
| billing)                          |                                   |
|                                   |                                   |
| Green tags [     ]{.underline}AEO |                                   |
| kWh x[     ]{.underline}c/kWh =   |                                   |
| \$[     ]{.underline}             |                                   |
|                                   |                                   |
| State or other production         |                                   |
| incentive [     ]{.underline}AEO  |                                   |
| kWh x[     ]{.underline}c/kWh =   |                                   |
| \$[     ]{.underline}             |                                   |
|                                   |                                   |
| Other incentive                   |                                   |
| [     ]{.underline}AEO kWh        |                                   |
| x[     ]{.underline}c/kWh =       |                                   |
| \$[     ]{.underline}             |                                   |
|                                   |                                   |
| Describe Other Incentive:         |                                   |
|                                   |                                   |
| **Annual Savings/Income** =       |                                   |
| \$**[     ]{.underline}**         |                                   |
|                                   |                                   |
| Provide calculation here or       |                                   |
| attach a separate sheet:          |                                   |
|                                   |                                   |
| Describe (or attach) the          |                                   |
| applicable electrical tariff:     |                                   |
|                                   |                                   |
|                                   |                                   |
| Describe any other incentives or  |                                   |
| revenue sources not included in   |                                   |
| the simple payback calculation.   |                                   |
| This may include state rebate     |                                   |
| programs or renewable energy      |                                   |
| credit programs.                  |                                   |
+-----------------------------------+-----------------------------------+
| **Section g: Equipment            |                                   |
| procurement.**                    |                                   |
+-----------------------------------+-----------------------------------+
| Certify that \"open and free\"    |                                   |
| competition will be used in the   |                                   |
| procurement of components in a    |                                   |
| manner consistent with the        |                                   |
| requirements of 7 CFR part 3015   |                                   |
| of this title. See the Technical  |                                   |
| Requirements Certifications form. |                                   |
+-----------------------------------+-----------------------------------+
| **Section h: Equipment            |                                   |
| installation.**                   |                                   |
+-----------------------------------+-----------------------------------+
| The equipment must be installed   |                                   |
| in accordance with all applicable |                                   |
| safety and work rules. See the    |                                   |
| Technical Requirements            |                                   |
| Certifications form.              |                                   |
+-----------------------------------+-----------------------------------+
| **Section i: Operations and       |                                   |
| maintenance.**                    |                                   |
+-----------------------------------+-----------------------------------+
| Design life of system:            |                                   |
|                                   |                                   |
| Indicate length (years) of        |                                   |
| warranty for the following:       |                                   |
|                                   |                                   |
| Design       Turbine              |                                   |
| Inverter       Battery            |                                   |
| Parts and Labor                   |                                   |
|                                   |                                   |
| Other:                            |                                   |
|                                   |                                   |
| Describe:                         |                                   |
|                                   |                                   |
| Does the project have unique      |                                   |
| operation issues? Yes No          |                                   |
|                                   |                                   |
| If yes, please explain:           |                                   |
+-----------------------------------+-----------------------------------+
| **Section j: Dismantling and      |                                   |
| disposal of project.**            |                                   |
+-----------------------------------+-----------------------------------+
| Is there a plan for dismantling   |                                   |
| and disposal? Yes No              |                                   |
|                                   |                                   |
| Please describe:                  |                                   |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+

**Technical Requirements Certifications**

**Small Wind: 100 kW or less and total project cost of \$200K or less**

WHEREAS, \_\_     \_\_\_\_\_\_\_\_\_\_\_\_\_\_ herein call the
"Grantee", intends to obtain assistance from the United States of
America, acting through the U.S. Department of Agriculture, herein
called the "Government", acting under the provisions of the Renewable
Energy Systems and Energy Efficiency Improvements Program, 4280-B
regulations.

NOW THEREFORE, the Grantee hereby certifies the following technical
requirements have been or will be met:

1.  The proposed project will be installed according to applicable
    federal, state, and local codes.

2.  For this project, "open and free" competition will be used for the
    procurement of components in a manner consistent with the
    requirements of 7 CFR part 3015 of this title.

3.  Equipment installation will be made in accordance with all
    applicable safety and work rules. Additionally, the Grantee agrees
    that upon successful system installation and following established
    operation, the successful applicant must deliver invoices and
    evidence of payment.

4.  Project components will be dismantled or disposed of as appropriate
    or if necessary to ensure public safety at the end of their useful
    lives.

5.  Project developer will hold appropriate liability insurance.

6.  The project will be completed within two years from date of the
    approval.

IN WITNESS WHEREOF, I have executed this       day of     , 20     .

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Grantee

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Grantee