**Contact Name:**

**Phone Number:**

**Date Completed:**

**Directions for Use:**

**For information on project reporting go to w ww.epa.gov/chp/partnership/reporting.html or call the CHP Partnership help line at (703) 373-8108.** 

**Ac count - Name**  **(Business Name) Project Name**  **Project A ddress** 

**Data Entry Guidelines:**  **Code name may be used for**  **planned projects** - Please add new planned projects or new operational projects to the worksheet titled "New Projects." - All fields are required unless noted otherwise. - For column heading definitions, see "Definitions" worksheet. 

# CHP Partnership Project Data Reporting Form

**Date returned to CHPP (EPA use):** 

- The information EPA currently has on each project has been filled into the appropriate field, please make changes or updates in **BOLD**

.**For information on project reporting go to w ww.epa.gov/chp/partnership/reporting.html or call the CHP Partnership help line at (703) 373-8108.** 

**Project City Project** 

**State Size (MW)** 

**(i.e. Nameplate capacity**  **) Ac**  **tual Startup Date**  or **Projected**

**Startup Date**

**Postal Code (e.g., CA**  **for California)**  **Please provide an**

**estimate for both operational and**  **planned projects Month/ y**  **ear if Operational**  or **Estimate**

**month/ y ear if**  **Planned** - Please add new planned projects or new operational projects to the worksheet titled "New Projects." - The information EPA currently has on each project has been filled into the appropriate field, please make changes or**Stage Project Ow**  **ner/ Operator**  **Primary Fuel Ty**  **pe**

**Suspect, Prospect, Proposed, In**  **Engineering, In Construction,**  **Operational, or Lost An**  **thropogenic Biomass, Biogenic Biomass, Coal, Natural**  **Gas, or Waste Heat Is There A**  **nother Fuel? Percentage of Pow**  **er Exported to the Grid**  **Prime Mover Ty pe** 

**Yes or No (Not including back**

**up fuel) Use N/A**  **if not applicable**  **Backpressure Steam Turbine,**

**Combustion Turbine, Condensing Steam Turbine, Extracting Steam**  **Turbine, Fuel Cell, Reciprocating Engine, Microturbine, Stirling Engine,**  **Organic Rankine Cy cle, or Other** **Prime Mover Brand**

**(Optional) Market** 

**Make and Model Ag**  **riculture, A irport, A**  **thletic Facility**  **, Community**

**Center, Data Center, District Energy**  **, Ethanol, Food Processing,**  **Grocery , Hospital,**  **Hotel/Casino, Industrial, Landfill, Military**  **, Multifamily Housing, Museum, Nursing**  **Home/A ssisted Living, Office,**  **Pharmaceutical, Primary**  **/Secondary**

**School, Prison, Utility**  **, Wastew ater**  **Treatment, or Zoo Contact Name:** 

**Phone Number:**

**Date Completed:**

**Directions for Use:**

**For information on project reporting go to w ww.epa.gov/chp/partnership/reporting.html or call the CHP Partnership help line at (703) 373-8108.** 

**Ac count - Name**  **(Business Name) Project Name**  **Project A ddress** 

**Data Entry Guidelines:**  **Code name may be used for**  **planned projects** - Please add new planned projects or new operational projects to the worksheet titled "New Projects." - All fields are required unless noted otherwise. - For column heading definitions, see "Definitions" worksheet. 

# CHP Partnership Project Data Reporting Form

**Date returned to CHPP (EPA use):** 

- The information EPA currently has on each project has been filled into the appropriate field, please make changes or updates in **BOLD**

.**For information on project reporting go to w ww.epa.gov/chp/partnership/reporting.html or call the CHP Partnership help line at (703) 373-8108.** 

**Project City Project** 

**State Size (MW)** 

**(i.e. Nameplate capacity**  **) Ac**  **tual Startup Date**  or **Projected**

**Startup Date**

**Postal Code (e.g., CA**  **for California)**  **Please provide an**

**estimate for both operational and**  **planned projects Month/ y**  **ear if Operational**  or **Estimate**

**month/ y ear if**  **Planned** - Please add new planned projects or new operational projects to the worksheet titled "New Projects." - The information EPA currently has on each project has been filled into the appropriate field, please make changes or**Stage Project Ow**  **ner/ Operator**  **Primary Fuel Ty**  **pe**

**Suspect, Prospect, Proposed, In**  **Engineering, In Construction,**  **Operational, or Lost An**  **thropogenic Biomass, Biogenic Biomass, Coal, Natural**  **Gas, or Waste Heat Is There A**  **nother Fuel? Percentage of Pow**  **er Exported to the Grid**  **Prime Mover Ty pe** 

**Yes or No (Not including back**

**up fuel) Use N/A**  **if not applicable**  **Backpressure Steam Turbine,**

**Combustion Turbine, Condensing Steam Turbine, Extracting Steam**  **Turbine, Fuel Cell, Reciprocating Engine, Microturbine, Stirling Engine,**  **Organic Rankine Cy cle, or Other** **Prime Mover Brand**

**(Optional) Market** 

**Make and Model Ag**  **riculture, A irport, A**  **thletic Facility**  **, Community**

**Center, Data Center, District Energy**  **, Ethanol, Food Processing,**  **Grocery , Hospital,**  **Hotel/Casino, Industrial, Landfill, Military**  **, Multifamily Housing, Museum, Nursing**  **Home/A ssisted Living, Office,**  **Pharmaceutical, Primary**  **/Secondary**

**School, Prison, Utility**  **, Wastew ater**  **Treatment, or Zoo**

### Column Heading

**Ac count-Name**  **Project Name Project A** **ddress Project City**  **Project State Size (MW)**  **Ac tual Startup Date**  **Projected Startup Date Stage**  **Suspect Prospect**  **Proposed**

**In Engineering In Construction**  **Operational Lost**  **Project Owner/Operator Primary Fuel Type** 

**Anthropogenic Biomass Biogenic Biomass** 

**Coal Natural Gas**  **Waste Heat Is There A**  **nother Fuel? Percentage of Power Exported to Grid** 

**Prime Mover Type Prime Mover Brand**  **Ma rket**  

# CHP Partnership Project Data Reporting Form

### Definition

Business name Name of CHP project Address of CHP project City of CHP project State of CHP project Nameplate capacity

of CHP system (MW ) Month and year when CHP project became operational Month and year when CHP project is expected to become operational Stage of development of CHP project Pre-qualification has determined that CHP could be appropriate for site Initial feasibility

screening is underway or has been completed Contracts are being negotiated or have been signed Detailed engineering design is underway (engineering/construction drawings are being completed and equipment is being chosen) CHP project is under construction CHP project is operational CHP project is no longer operational or is no longer associated with your business The owner/operator of CHP project Prim ary fuel used by

CHP project Human-made materials that can be combusted for electricity and heat production, such as waste tires or portions of MSW Organic biomass, such as wood, agricultural crops, landfill gas, and digester gas Coal Natural Gas Wa ste heat from a thermal process used to produce power Yes or no (not including back-up fuel) Percentage of Power Exported to Grid The CHP project prime mover (see CHP Catalog of CHP Technologies at: www.epa.gov/chp/basic/catalog.html ) Manufacturer of prime mover Market sector served by the CHP system using the market list provided 

# CHP Partnership Project Data Reporting Form