Fixed Backup Power Interest Form Applicant Information Who is the best person to discuss back-up generator options (if you have a Facilities Manager, this may be the best contact for us to work with)? Please register the name of the customer who manages the SDG&E account of your residence. This will ensure there are not any delays in attempting to get permission (through a signed customer agreement) for the installation from the primary SDG&E account holder. Contact First Name Contact Last Name SDG&E Account Number (enter numbers only; no spaces and no dashes) Email Address Primary Contact Home Office Cell Phone Number (enter numbers only; no spaces and no dashes) Secondary Contact Home Cell Office Phone Number (enter numbers only; no spaces and no dashes) What is your preferred method of contact? Email Phone Number Cell Number When is the best time to reach you? A.M. P.M. Considerations Installation Address Qualified Home Address City/Town ZIP/Postal Code Are you the current owner of your residence? Yes No Was your house built before 1972? Yes No I don't know What are the energy sources that power your household? Check all that apply. Gas Propane Electricity Do you already have an installed back-up generator? Yes No Kind of Generator Are there any specific reasons you need back-up power? Check all that apply. Medical needs Home business impacts Increased outages in recent years Are there any special site considerations (space constraints, sound/noise, type of fuel available onsite (propane, NG, none), running a business from your home, etc.)? Do you have anything else you would like us to know? When could this project start? In the next month next 2-3 months 3 or more months I acknowledge By submitting this form, I acknowledge that if there is not a propane tank on the property, a propane tank purchase (or rental) and ongoing fuel expenses are not covered by SDG&E and are the sole responsibility of the SDGE customer. I acknowledge By submitting this form, I acknowledge that submission does not prequalify, nor ensure a backup generator installation. Submit