NEW CONNECTION Heat Pump Application Form C

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NEW CONNECTION Heat Pump Application Form C greater than 75A per phase Please submit your completed application form to: Northern Powergrid, Network Connections, Alix House, Falcon Court, Stockton-on-Tees, TS18 3TU If you need any help to complete this form please contact us: getconnected@northernpowergrid.com 0800 011 3433 Opening hours: Monday - Friday Saturday 8:00am - 8:00pm 9:00am - 5:00pm Northern Powergrid Heat Pump Form C

HELPING YOU FILL IN THIS FORM Help with completing the form and getting your heat pump connected If you need any more help with completing this form, please go to our help and information guidance at the back of the application form or call us on 0800 011 3433. Use this form to apply to connect new or additional heat pump equipment rated over 75A per phase. This form shall be used for equipment rated up to 75A per phase that does not meet the requirements of standards BS EN 61000-3-2 or BS EN 61000-3-12 and BS EN 61000-3-3 or BS EN 61000-3-11. Note that these standards define limits that control specific types of power quality disturbances. Where the equipment meets the requirements of standards BS EN 61000-3-2 or BS EN 61000-3-3 use Form A. Where the equipment meets the requirements of standards BS EN 61000-3-11 or BS EN 61000-3-12 use Form B. The application must be made in advance of connection. Please note that the normal standard of service for approval of connection are as follows: 25 working days - Properties with potentially disruptive loads 35 working days - Properties requiring high voltage network works. Please note any reinforcement costs may be recharged to the customer. SECTION 1 - INSTALLATION ADDRESS SECTION 7 - HEAT PUMP SYSTEM Please provide your full installation address. Please provide full details of t he heat pump system to be installed. SECTION 2 - INSTALLATION CUSTOMER DETAILS Please provide the full customer and contact details SECTION 8 - MAXIMUM CAPACITY SECTION 3- INSTALLER DETAILS Please provide details on the installer who is undertaking the work at the aforementioned property. Please provide details of the maximum capacity requirements for the whole of the customers installation. SECTION 9 - CONFIRMATION OF INSTALLATION SECTION 4 - EXISTING SPACE & WATER HEATING SYSTEM Please provide signature and details of individual installer. If there is existing space and water heating equipment please provide full details. SECTION 10 - DATA PROTECTION STATEMENT SECTION 5 - EXISTING SPACE & WATER HEATING TO BE RETAINED SECTION 11- HEAT PUMP SYSTEM POWER QUALITY DATA (Essential) Please provide full details of any existing equipment to be retained. Please provide the heat pump system power quality data. The manufacturer may need to be consulted to assist. SECTION 6 - NEW SPACE & WATER HEATING TO BE RETAINED Please provide full details of any new equipment to be installed. 2 Northern Powergrid Heat Pump Form C

* indicates mandatory field Section 1 - INSTALLATION ADDRESS* Address* Postcode* MPAN The unique identifying number for the electricity meter at the property Section 2 - INSTALLATION CUTOMER DETAILS* Name* Telephone* Address if different from the installation address Postcode Section 3 - INSTALLER DETAILS Contact Person* Telephone* Address* Postcode* E-mail address* Section 3 - INSTALLATION DATE Date of installation* MM/YYYY 3 Northern Powergrid Heat Pump Form C

Section 4 - EXISTING SPACE & WATER HEATING EQUIPMENT Type: Electric/Gas/Oil/LPG/Other If Electric, please complete the following: Direct acting Storage Hot water immersion heater Heat Pump system Other inc. heaters 2 Heaters 3 Main Boost Compressor Boost Back-up Flow boilers kw kw kw Kw kw electrical kw electrical kw electrical kw electrical 1. The manufacturer must verify this. 2 Direct acting heating these are directly connected to the mains (e.g. convector or panel heaters). 3 Storage heaters These retain heat inside the storage heater, are charged over night to store heat and release heat during the say. Storage heaters often use Economy 7 electricity tariff at night. Section 5 EXISTING SPACE & WATER HEATING EQUIPMENT TO BE RETAINED Direct acting Storage Hot water immersion heater Heat Pump system Other inc. heaters 2 Heaters 3 Main Boost Compressor Boost Back-up Flow boilers kw kw kw Kw kw electrical kw electrical kw electrical kw electrical Section 6 NEW SPACE & WATER HEATING EQUIPMENT Direct acting Storage Hot water immersion heater Heat Pump system Other inc. heaters 2 Heaters 3 Main Boost Compressor Boost Back-up Flow boilers kw kw kw Kw kw electrical kw electrical kw electrical kw electrical Section 7 HEAT PUMP SYSTEM DETAILS Manufacturer Type reference Operating voltage (V) Phase (1 or 3) Heat pump system maximum electrical power requirement Volts kva Note: Heaters not fitted in the heat pump unit to boost hot water or as a back-up should be recorded as new equipment above or as existing equipment to be retained below as appropriate. Section 8 MAXIMUM CAPACITY Required Maximum Capacity for Whole Customer Installation kva 4 Northern Powergrid Heat Pump Form C

Section 9 CONFIRMATION OF INSTALLATION I confirm that the electrical installation noted above will be installed and commissioned as noted above and that the equipment meets the requirements of BS EN 61000-3-2 and BS EN 61000-3-3 for harmonic emissions and voltage change. The customer at the above address has been advised that commissioning of the installation may only take place when the Network Operator has completed any reinforcement works the supply network requires. Name* Date Accreditation / Qualification Signature* On behalf of Installer* Section 10 DATA PROTECTION STATEMENT Data Protection We will use the details you provide to process your connection request and to monitor the service we provide. Your details will be kept securely and will not be used for marketing purposes. We have an obligation to provide the results of customer satisfaction surveys on the services we provide to Ofgem, the electricity industry regulator. Therefore you may be contacted by our appointed Market Research Company to complete a brief satisfaction survey of our service delivery performance. If you do not wish to be contacted as part of these surveys please tick 5 Northern Powergrid Heat Pump Form C

Section 11 HEAT PUMP SYSTEM POWER QUALITY DATA (Essential) Note: The manufacturer may need to be consulted to complete this technical data HEAT PUMP APPLICATION FORM C 11.1 - Heat Pump System Details Manufacturer Type reference 11.2 - EC Declaration of Conformity Attach the heat pump manufacture s EC Declaration of Conformity as produced in association with the EMC Directive Attached: Yes / No 11.3 - Power Quality: Harmonic Emissions Harmonic Emissions Rated Current (A) Operating Voltage (V): Phases Maximum Value of Harmonic Currents for each Harmonic Order Harmonic Order h Emission Current (A) Harmonic Order h Emission Current (A) Harmonic Order h 2 20 38 3 21 39 4 22 40 5 23 41 6 24 42 7 25 43 8 26 44 9 27 45 10 28 46 11 29 47 12 30 48 13 31 49 14 32 50 15 33 16 34 17 35 18 36 19 37 Emission Current (A) 6 Northern Powergrid Heat Pump Form C

Section 11.4 Power Quality: Voltage Fluctuations and Flicker Power Quality. Voltage fluctuations and Flicker. The tests/calculations should be carried out by the heat pump manufacturer, with typical worst case cycling on and off. The results should be normalised to the standard source impedance Zref, if this results in figures above the limits set in EN 61000-3-3 then a suitable Maximum source Impedance Zmax should be identified as required by EN 61000-3-11. Manufacturer states Heat Pump System meets technical requirements of EN/IEC 61000-3-3? Note: Where the heat pump system meets the technical requirements of BS EN/IEC 61000-3-3 then there is no need to complete the rest of this table. Manufacturer states Heat Pump System complying with EN/IEC 61000-3-11 provided that the source impedance is no more than Z max? Manufacturer states Heat Pump System complying with BS EN/IEC 61000-3-11 provided that service current capacity 100A per phase? Yes/No Yes/No Yes/No d max d c d(t) T max (8 new) P st P lt 2 hours Measured Values at test impedance Normalised to standard impedance Normalised to required maximum impedance Limits set under BS EN 61000-3- 11 & 61000-3-3 4% 3.3% 3.3% 500ms 1.0 0.65 Z test R ohms X ohms Z ref R 0.24 * 0.4 ^ 0.48 # ohms X 0.15 * 0.25 ^ 0.3 # ohms Z max R ohms X ohms 8 T max applied to comply with new revision * Applies to three phase heat pump systems ^ Applies to single phase heat pump systems # Applies to interphase connected heat pump systems using two phases on a three phase system Note: Z max must take account of multiple devices using the scaling down detailed in EN 61000-3-11 Section 6.2.2. 7 Northern Powergrid Heat Pump Form C

11.5 - Heat Pump Compressor(s) Heat Pump Compressor(s) Aggregate Electrical Rating kw HP Number of Compressors Single/Twin/Other Time-delay Between Starts if >1 Compressor Minutes Seconds Compressor 1: Nominal Voltage Volts Phases :1 or 3-phase 1-phase 3-phase Electrical Rating kw HP Maximum Starting Current A Minimum Time Between Starts of Hours Minutes Seconds Compressor Method of Starting Please indicate Starting Power Factor Direct On Line Star/Delta Auto-transformer Electronic Soft Start Variable Speed. Slip Ring Rotor Resistance 1-Phase Capacitor Start Single Phase Series Parallel Other...... Compressor 2: Nominal Voltage Volts Phases: 1 or 3-phase Electrical Rating kw HP Maximum Starting Current Minimum Time Between Starts of Compressor 2 Compressor Method of Starting Starting Power Factor Direct On Line Star/Delta Auto-transformer Electronic Soft Start Variable Speed. A Hours Minutes Seconds Slip Ring Rotor Resistance 1-Phase Capacitor Start Single Phase Series Parallel Other...... 8 Northern Powergrid Heat Pump Form C

11.6 - Back-up Heater Details Back-up Heater Details Nominal Voltage Volts Phases 1-phase 3-phase Make Model Rating or Aggregate Rating kw A Number of heating stages switchable individually Stage 1 kw Stage 6 kw Stage 2 kw Stage 7 kw Stage 3 kw Stage 8 kw Stage 4 kw Stage 9 kw Stage 5 kw Stage 10 kw 11.7 - Boost Heater Details Boost Heater Details Nominal Voltage Volts Phases 1-phase 3-phase Make Model Rating or Aggregate Rating kw A Number of heating stages switchable individually Stage 1 kw Stage 6 kw Stage 2 kw Stage 7 kw Stage 3 kw Stage 8 kw Stage 4 kw Stage 9 kw Stage 5 kw Stage 10 kw 9 Northern Powergrid Heat Pump Form C

kvar kw HEAT PUMP APPLICATION FORM C 11.8 - Description of Power Variations (with particular attention to step changes, ramped changes and repetition periods). Use most appropriate scale. Show minimum time between changes. 100 90 80 70 60 50 40 30 20 10 0 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Time (s) Repetition Period: Seconds Minutes Hours Days 100 90 80 70 60 50 40 30 20 10 0 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Time (s) Repetition Period: Seconds Minutes Hours Days 10 Northern Powergrid Heat Pump Form C