5900-xxx Reporting Form

---

Overview

Existing Projects
New Projects
Definitions

---

Sheet 1: Existing Projects

Contact Name:

Phone Number:

Date Completed:

Date returned to CHPP (EPA use):

Directions for Use:

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

- 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.

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

Account - Name (Business Name)

Project Name

Project Address

Project City

Project State

Size (MW) (i.e. Nameplate capacity)

Actual Startup Date

or

Projected Startup Date

Stage

Project Owner/ Operator

Primary Fuel Type

Is There Another Fuel?

Percentage of Power Exported to the Grid

Prime Mover Type

Prime Mover Brand (Optional)

Market

Data Entry Guidelines:

Code name may be used for planned projects

Postal Code (e.g., CA for California)

Please provide an estimate for both operational and planned projects

Month/ year if Operational

or

Estimate month/ year if Planned

Suspect, Prospect, Proposed, In Engineering, In Construction, Operational, or Lost

Anthropogenic Biomass, Biogenic Biomass, Coal, Natural Gas, or Waste Heat

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 Cycle, or Other

Make and Model

Agriculture, Airport, Athletic Facility, Community Center, Data Center, District Energy, Ethanol, Food Processing, Grocery, Hospital, Hotel/Casino, Industrial, Landfill, Military, Multifamily Housing, Museum, Nursing Home/Assisted Living, Office, Pharmaceutical, Primary/Secondary School, Prison, Utility, Wastewater Treatment, or Zoo

---

Sheet 2: New Projects

Contact Name:

Phone Number:

Date Completed:

Date returned to CHPP (EPA use):

Directions for Use:

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

- 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.

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

Account - Name (Business Name)

Project Name

Project Address

Project City

Project State

Size (MW) (i.e. Nameplate capacity)

Actual Startup Date

or

Projected Startup Date

Stage

Project Owner/ Operator

Primary Fuel Type

Is There Another Fuel?

Percentage of Power Exported to the Grid

Prime Mover Type

Prime Mover Brand (Optional)

Market

Data Entry Guidelines:

Code name may be used for planned projects

Postal Code (e.g., CA for California)

Please provide an estimate for both operational and planned projects

Month/ year if Operational

or

Estimate month/ year if Planned

Suspect, Prospect, Proposed, In Engineering, In Construction, Operational, or Lost

Anthropogenic Biomass, Biogenic Biomass, Coal, Natural Gas, or Waste Heat

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 Cycle, or Other

Make and Model

Agriculture, Airport, Athletic Facility, Community Center, Data Center, District Energy, Ethanol, Food Processing, Grocery, Hospital, Hotel/Casino, Industrial, Landfill, Military, Multifamily Housing, Museum, Nursing Home/Assisted Living, Office, Pharmaceutical, Primary/Secondary School, Prison, Utility, Wastewater Treatment, or Zoo

---

Sheet 3: Definitions

Column Heading	Definition
Account-Name	Business name
Project Name	Name of CHP project
Project Address	Address of CHP project
Project City	City of CHP project
Project State	State of CHP project
Size (MW)	Nameplate capacity of CHP system (MW)
Actual Startup Date	Month and year when CHP project became operational
Projected Startup Date	Month and year when CHP project is expected to become operational
Stage	Stage of development of CHP project
Suspect	Pre-qualification has determined that CHP could be appropriate for site
Prospect	Initial feasibility screening is underway or has been completed
Proposed	Contracts are being negotiated or have been signed
In Engineering	Detailed engineering design is underway (engineering/construction drawings are being completed and equipment is being chosen)
In Construction	CHP project is under construction
Operational	CHP project is operational
Lost	CHP project is no longer operational or is no longer associated with your business
Project Owner/Operator	The owner/operator of CHP project
Primary Fuel Type	Primary fuel used by CHP project
Anthropogenic Biomass	Human-made materials that can be combusted for electricity and heat production, such as waste tires or portions of MSW
Biogenic Biomass	Organic biomass, such as wood, agricultural crops, landfill gas, and digester gas
Coal	Coal
Natural Gas	Natural Gas
Waste Heat	Waste heat from a thermal process used to produce power
Is There Another Fuel?	Yes or no (not including back-up fuel)
Percentage of Power Exported to Grid	Percentage of Power Exported to Grid
Prime Mover Type	The CHP project prime mover (see CHP Catalog of CHP Technologies at: www.epa.gov/chp/basic/catalog.html)
Prime Mover Brand	Manufacturer of prime mover
Market	Market sector served by the CHP system using the market list provided