Form 62 0686 PDF Details

In order to submit a Tax form, you need the 62 0686 form. This includes both state and federal tax returns. It's important to make sure that you have the most recent version of the form, as well as all the necessary supporting documentation, in order to ensure a smooth submission process. You can download the form from the IRS website, or pick it up at your local post office or library. Always double-check that you have everything you need before submitting your taxes!

QuestionAnswer
Form NameForm 62 0686
Form Length7 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 45 sec
Other namesELEC_FORMS_62 0686_ti pg&e care application fillable form

Form Preview Example

Pacific Gas and Electric Company

Revised

Cal. P.U.C. Sheet No.

28313-E

San Francisco, California

Cancelling Revised

Cal. P.U.C. Sheet No.

27581-E

U 39

 

 

 

Electric Sample Form No. 62-0686

Application for Service -- Agricultural Service

Please Refer to Attached

Sample Form

Advice Letter No: 3442-E-A

Issued by

Date Filed

April 22,

2009

Decision No.

Brian K. Cherry

Effective

May 22,

2009

 

Vice President

Resolution No.

 

 

1C10

Regulatory Relations

 

 

 

Application for Service

Agricultural Service

Please complete this application and submit the completed form to PG&E Application for Service at P.O. Box 24047, Fresno, CA 93706- 2010. You may also submit applications at http://www.pge.com/mybusiness/customerservice/otherrequests/newconstruction or call 1-877- PGE-SRVC.

* Indicates optional fields.

Project Type

Applicants will be served under an agricultural rate schedule if 70% or more of the annual energy use on the meter is for agricultural end- uses. Agricultural end-uses consist of: (a) growing crops, (b) raising livestock, (c) pumping water for irrigation of crops, or (d) other uses which involve production for sale. (Note: PG&E’s Electric Rule 1 contains the complete qualification criteria for agricultural rates).

What percentage of the annual energy use will be for agricultural end-uses?

 

%

New Agricultural Service

Additional Load or Equipment to Existing Agricultural Service

Number of Buildings

 

Number of Services

 

 

 

 

Project Information

Gas Service

Electric Overhead Service

Project Address or Lot Number

Nearest Cross Street

Electric Underground

Date Initial Service Needed

City

 

 

County

Zip

 

 

 

 

 

 

 

 

*Assessor’s Parcel No.

 

 

 

*Building Permit No.

 

 

 

 

 

 

 

 

 

Applicant / Company Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Individual

Partnership

Corporation

 

 

Limited Liability Corporation

Governmental Agency

Sole Proprietor

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Day Phone

 

 

 

 

*Cell Phone

*Fax

*Email address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Correspondence will be sent via e-mail)

Applicant Mailing Address

 

 

 

 

 

City

 

 

S

tate

 

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contract Information

Legal Name to appear on contract

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Individual

Partnership

 

Corporation

Limited Liability Corporation

 

 

Governmental Agency

Sole Proprietor

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*State of incorporation or LLC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of person authorized to sign contracts

 

 

 

 

*Title

 

 

 

 

 

 

 

 

 

 

 

 

 

(First Name, Middle Initial, Last Name)

 

 

 

 

 

 

Mailing address for contract

 

 

 

 

 

City

State

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Representative

Information (Party who will relay project information and updates to the PG&E representative)

 

 

 

 

 

 

 

 

 

 

 

Name of Representative

 

 

 

 

 

 

 

Day Phone

 

 

 

*Cell Phone

 

*Fax

 

*Email address

 

 

 

 

 

 

 

 

 

 

 

 

Form 62-0686

Page 1 of 6

Advice 3008-G-A/3342-E-A

May 2009

Mailing address

 

City

State

Zip

 

 

 

 

 

 

 

 

 

*Contractor’s Name

 

*Contractor’s Phone

 

 

 

 

 

 

 

 

 

 

 

 

Credit Information (Party responsible for energy use after the meter is installed)

Name/Company Name to appear on bill

 

 

 

 

 

Day Phone

 

*Evening Phone

 

 

 

 

 

(First Name, Middle Initial, Last Name)

 

 

 

 

 

 

Individual

Partnership

Corporation

Limited Liability Corporation

Governmental Agency

Sole Proprietor

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing address for bill

 

 

City

 

 

 

State

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Does the customer currently have service with PG&E?

No

Yes

*If yes, please provide the PG&E Account Number

*Do you want the new service included on your existing bill?

No

Yes

*NAICS (North America Industrial Classification System) Code

 

*Business Activity

 

 

*Desired Electric Rate Schedule

 

*Desired Gas Rate Schedule

 

 

 

 

 

 

 

 

 

 

 

The applicant is required to select an Agricultural Rate schedule before receiving service. If you want additional information on rate options or want to request a free rate analysis, visit http://www.pge.com/about/rates/rateinfo/rateoptions/agricultural/ or call 1-877-PGE-SRVC.

Application and Design and Installation Options

As an applicant for new gas or electric service, you can choose either PG&E or a qualified contractor to design new gas/electric distribution and/or service facilities. You can also choose either PG&E or a qualified contractor to construct all or a portion of new gas/electric distribution and/or service facilities. PG&E will provide you with a bid for the design and the construction work, to assist you in making a selection. You will then have the opportunity to choose either a qualified contractor to perform the design/or construction work.

In accordance with PG&E’s filed tariffs, electric trenching, conduits, substructures and gas service trenching are the applicant’s responsibility. Once you make a decision about who will perform the work, if you subsequently change your selection, you will be responsible for any re-engineering charges incurred as a result of that change.

You should become familiar with the applicant design installation requirements, including PG&E’s Applicant Design Guide and General Terms and Conditions, before you make your selection. For copies of these documents and/or for additional information, visit www.pge.com/mybusiness/customerservice/otherrequests/newconstruction/processguide/step1/appdes.shtml or request information by calling 1-877-PGE-SRVC.

PG&E must provide project specific information to design contractors. PG&E can provide this information sooner if we know whether or not you are considering using a design contractor to design gas/electric distribution or service facilities.

Providing this information on this Application is voluntary and is not binding. PG&E will provide you with a bid for the design work regardless of whether or not you answer this question now and will not require a final decision from you until later in the process.

Are you currently planning to use a design contractor?

Yes

No

Construction Information

**Please note if you have selected Electric Overhead Service” without Gas Service” all trench related questions become optional fields.

Joint trench drawing to be prepared by:

Applicant

PG&E

Not required

Who will trench and backfill for the distribution facilities? Applicant / Elec PG&E / Elec

Date Joint Trench Required

Form 62-0686

Page 2 of 6

Advice 3008-G-A/3342-E-A

May 2009

Proposed distribution trench occupants or joint pole occupants: (check all that apply)

Electric

Gas

Phone

CATV

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Who will install distribution conduit and substructures?

Applicant

PG&E

 

 

 

 

 

Who will trench and backfill for the service facilities?

Applicant / Gas

PG&E / Gas

Date Joint Trench Required

 

 

 

 

 

 

 

 

 

Applicant / Elec

PG&E / Elec

 

 

 

 

Proposed service trench occupants or joint pole occupants: (check all that apply)

 

Electric

Gas

Phone

CATV

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Who will install service conduit and substructures?

Applicant

PG&E

 

 

 

 

 

 

*Transformer type requested:

Padmounted

Subsurface (additional Special Facilities charges may apply)

 

 

Water, sanitary sewer, storm drain, low pressure gas, oil or other fluid carrying piping or facilities or private utilities (e.g. fire alarm, private streetlight systems, private phone, private CATV or gate controllers) are not permitted in a PG&E occupied joint trench.

General Construction Information

Include on this application any eligible Rule 20B or Rule 20C conversion work or any eligible relocation work.

*Will temporary electric service be required?

No

Yes

Date needed

*Will temporary gas service be required?

No

Yes

Date needed

 

 

If, yes please complete the following:

 

 

 

 

 

 

 

*Will Temporary Service power be operated for less than one year?

No

 

Yes

Have you ever completed a temporary power project with us before?

No

 

Yes

*Who will trench and backfill for Temporary Service?

 

 

 

 

 

 

Applicant/Gas

PG&E/Gas

 

Applicant/Electric

 

 

PG&E/Electric

Electric Temporary Services

Panel, Main Breaker Size

 

amps

 

 

 

 

 

 

 

 

Have you ever completed a temporary power project with us before?

No

*Will Applicant or Contractor Install Pole?

No

Yes

 

 

Gas Temporary Services

 

 

 

 

 

 

 

 

 

 

*Gas Service Delivery Pressure Requested:

¼ psig

Other

 

psig)

*Number of Meters at each service location?

 

 

 

 

 

 

 

 

*Total Gas Load

 

 

 

 

 

 

 

 

 

 

 

 

 

Will existing PG&E electric overhead facilities require undergrounding?

 

 

No

Yes

Not sure

Date needed

 

 

 

 

 

 

Will any existing PG&E gas or electric facilities require relocation or removal?

No

Yes

Not sure

Date needed

 

Yes

Form 62-0686

Page 3 of 6

Advice 3008-G-A/3342-E-A

May 2009

Load Information

IN THE EVENT THAT APPLICANT SHALL MAKE ANY MATERIAL CHANGE EITHER IN THE AMOUNT OR CHARACTER OF THE APPLIANCES OR APPARATUS INSTALLED UPON THE PREMISES TO BE SUPPLIED BY PG&E, INCLUDING PANEL SIZE OR HOURS OF OPERATION. APPLICANT SHALL IMMEDIATELY GIVE PG&E WRITTEN NOTICE OF THIS FACT.

Operating Hours:

Hours per day

 

 

 

Days per week

 

 

Months per year

Typical operating hours: From

 

 

 

To

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Use Military 0-2300)

 

 

 

 

 

 

What months will this

 

 

January

 

 

 

February

 

March

 

April

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

facility operate?

 

 

May

 

 

 

June

 

 

July

 

August

 

 

 

 

 

 

 

 

 

 

 

All Months

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September

 

 

 

October

 

November

 

December

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please describe other operating characteristics

What type of crop or livestock are you producing? (if livestock, please state if they are raised for slaughter or sale, kept for breeding purposes, or boarded for others

Electric Load Information

Main Switch Size (Service Termination Enclosure)

amps Number of meters at each service location

 

Voltage: (select one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

120/240 Volt, 3-wire,

120/208Volt, 3-wire,

 

240/120 Volt, 4-wire,

208/120 Volt, 4-wire,

 

 

480/277 Volt, 4-wire,

 

Primary voltage (> 2,400 Volts)

 

Other (specify)

 

 

 

 

 

 

 

 

 

Single Largest 1Ø Motor (

 

 

hp) Total 1Ø Motors (

 

 

hp)

Single Largest 3Ø Motor (

hp)

Total 3Ø Motors (

hp)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Electric Connected Load

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Ø Motor:

 

 

motors at

hp each

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3Ø Motor:

 

 

motors at

hp each

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional electric load (if additional space is needed please attach a spread sheet using same format as below)

 

 

 

 

Number of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appliances

Phase

 

 

Description of Appliance

Connected Load

Units

 

 

 

 

 

 

_____

_____at_____

 

 

 

_____

kW

hp

tons

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_____

_____at_____

 

 

 

_____

kW

hp

tons

 

 

 

 

 

 

 

 

 

 

 

 

 

_____

_____at_____

 

 

 

_____

kW

hp

tons

 

 

 

 

 

 

 

 

 

 

 

 

 

_____

_____at_____

 

 

 

_____

kW

hp

tons

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Please provide motor codes for motors that have reduced voltage starting or are 25 hp and greater.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Will submersible pump(s) be installed?

No

Yes

 

 

 

 

 

 

 

 

 

 

 

 

Natural Gas Load Information

*If this is an existing service, what is the.*PG&E meter number.

Form 62-0686

Page 4 of 6

Advice 3008-G-A/3342-E-A

May 2009

Natural gas standard service delivery pressure is provided at ¼ psig (7” water column). Requests for elevated service delivery pressure require PG&E’s review and approval. If granted, elevated service delivery pressure may be reduced at any time due to PG&E operational needs. Special Facilities costs and cost-of-ownership charges may apply for elevated service delivery pressure. For further information, contact your local PG&E office and refer to Gas

Rule 2. (MBtu/h = 1,000 Btu/h)

Gas Service Delivery Pressure Requested:

1/4 psig

Other (

psig)

Number of meters at each service location

 

 

 

 

 

Check all that apply: (If additional space is required please attach a spreadsheet using same format as below)

Space Heating Equipment (

 

MBtu/h)

Boilers ( MBtu/h)

Water Heating (

 

MBtu/h)

Air Conditioning (

 

MBtu/h)

Cooking ( MBtu/h)

Dryers ( MBtu/h)

Other gas load (specify)

IMPORTANT NOTE: Do NOT install your electric main switch or gas house line until the meter location is approved by PG&E.

Self-Generation and Net Metering Options

If you are planning to install any self generation equipment, photovoltaic, or wind generation, additional applications for interconnection to PG&E’s electric system must be submitted and approved by PG&E prior to engineering for your new construction project. The information you provide on your generation interconnection application may affect the final PG&E design for your project.

For information on PG&E’s net metering programs, including eligibility guidelines, generation interconnection program application forms, links to the California Public Utilities Commission, Energy Commission and the US Department of Energy, visit www.pge.com/b2b/newgenerator/ or contact PG&E’s Generation Interconnection Services at (415) 972-5676.

Are you planning to install any self generation equipment?

 

Yes

 

No

 

 

 

 

 

If yes, please provide us with an estimate of the Generation proposed for this project.

*Total # of generation units

 

*Total output of all generation

*kW

 

*Generation Type

 

 

 

 

 

 

 

Attachment – 2 copies required

A. Detailed site plan showing roads, driveways, easements, right-of-ways, property lines, building and structure. B. Copies of all environmental permits and/or conditions of approval.

Applicant is responsible to identify all environmental requirements within said permits, approvals and/or conditions. For additional information visit http://www.pge.com/mybusiness/customerservice/otherrequests/newconstruction.

Agreement to Pay and Signature

I understand that service will be engineered and installed based upon the information provided here. I agree to pay PG&E, on demand, for all work PG&E performs and all costs PG&E incurs for this application for service. PG&E may cancel this Application for Service (a) if the application is incomplete and I do not provide all necessary supporting documents and project data after being notified by PG&E, (b) if I fail to provide an engineering advance within ninety days after one is requested by PG&E, or (c) if PG&E sends a proposed contract and I do not return the contract, with the required payment, within ninety days. If the project is postponed or cancelled, by either party, I will pay PG&E for all such work and costs incurred by PG&E prior to the postponement or cancellation. PG&E’s costs may include, for example, labor, material and supplies, (including long lead time materials), transportation, and other direct costs which PG&E allocates to such work. Incomplete information or any changes made at my request during the engineering, or after it is completed, will subject me to additional charges and may delay the establishment of service. I further agree to pay for any damage to new or existing PG&E facilities caused by my contractors or me. Service shall be subject to all of PG&E’s applicable tariff schedules on file with and authorized by the California Public Utilities Commission (CPUC) and shall at all times be subject to such changes or modifications as the CPUC may direct from time to time in the exercise of its jurisdiction.

I understand that PG&E may require an engineering advance to cover some or all of its costs for project review, design work and cost development in connection with this application for service. I understand that any advance will be based upon current costs and the amount of work anticipated by PG&E based upon the information submitted in this application. I understand that any advance will be credited against the amount I owe, applied to the amount I may owe on the resulting line extension agreement, or refunded to me without interest when PG&E has completed its engineering work or if the project has been cancelled or postponed.

Form 62-0686

Page 5 of 6

Advice 3008-G-A/3342-E-A

May 2009

Agreement to Pay and Signature continued

I have read the above information. I understand and agree with the provisions and my responsibilities.

Applicant's Signature

 

Print Name

 

Date

 

_

First Name, Middle Initial, Last Name

Form 62-0686

Page 6 of 6

Advice 3008-G-A/3342-E-A

May 2009

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Form 62 0686 conclusion process clarified (portion 1)

2. Once this section is completed, you're ready to insert the needed specifics in Applicant Company Name, Individual, Partnership, Corporation, Sole Proprietor, Other, Day Phone, Cell Phone, Applicant Mailing Address, Contract Information, Legal Name to appear on contract, Individual, Partnership, Corporation, and Sole Proprietor so that you can move on to the third part.

Filling in section 2 of Form 62 0686

Be really mindful when filling out Partnership and Partnership, because this is where a lot of people make mistakes.

3. In this part, review Name of Representative, Day Phone, Cell Phone, Fax, Email address, and Form Page of Advice GAEA May. Each one of these must be filled out with utmost accuracy.

Tips to prepare Form 62 0686 part 3

4. This next section requires some additional information. Ensure you complete all the necessary fields - Mailing address, City, Contractors Name, Contractors Phone, State, Zip, Credit Information Party, NameCompany Name to appear on bill, Day Phone, Evening Phone, Individual, Partnership, Corporation, Limited Liability Corporation, and Governmental Agency - to proceed further in your process!

Writing part 4 in Form 62 0686

5. To finish your form, the particular section includes some extra blanks. Typing in The applicant is required to, Application and Design and, As an applicant for new gas or, You should become familiar with, PGE must provide project specific, and Providing this information on this should wrap up everything and you can be done in a tick!

Form 62 0686 conclusion process shown (stage 5)

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