Load Requirement Form

HILCO Electric Cooperative, Inc

Load Requirement Form
Section A - PROJECT SITE
Name:

First NameLast Name
Contact Person:

First NameLast Name
Service Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:
Format: (000) 000-0000.
Mobile:
Format: (000) 000-0000.
Email Address:
example@example.com
Section B - ELECTRICIAN
Name:

First NameLast Name
Contact Person:

First NameLast Name
Phone:
Format: (000) 000-0000.
Mobile:
Format: (000) 000-0000.
Email Address:
example@example.com
Section C - SERVICE REQUESTED
Type of Structure:
** Commercial and / or Three-Phase services must complete Section E **
Service Type:
Service Entrance Conductors:
Size
Type:
Number of Conductors
Meter Base Size:
Note: All services require a main disconnect within 8 circuit feet of the meter base location. All services rated above a 320 amp meter base will be required to have an outside main disconnect.
Section D - ELECTRICAL LOAD INFORMATION (Please check the box that applies. If electric, then list the size.)
Total Square Footage
Square Footage with HVAC

Section D - ELECTRICAL LOAD INFORMATION (Please check the box that applies. If electric, then list the size.)

Rows	Electric	kW	or Tons	or Gas	Comments or Additional Info:
HVAC

Rows	Electric	kW	Tankless	or Gas	Comments or Additional Info:
Water Heater

Rows	Electric	kW	and HP	or Gas	Comments or Additional Info:
Pool/Hot Tub Heater and Pumps

Rows	Electric	or Gas	Comments or Additional Info:
Fireplace
Cooktop/Oven

HILCO Electric Cooperative, Inc