Fillable Form 2.: 2021 Smart Energy Existing Homes Heat (Santee Cooper)

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Form 2.: 2021 Smart Energy Existing Homes Heat (Santee Cooper)

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The Form 2.: 2021 Smart Energy Existing Homes Heat (Santee Cooper) form is 2 pages long and contains:

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  • 14 check-boxes
  • 59 other fields

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V2.2021 (3/1/2021)
Page 1 of 2
Instructions:
1.
Heat Pump Water Heater must be installed according to the requirements specified within the Smart Energy Existing Homes Program Guidelines (e.g.
ENERGY STAR qualified, installed in an unconditioned space, etc.).
2.
Santee Cooper must receive a completed copy of this form, as well as all required supplemental documentation prior to release of a loan and/or rebate
payments and thirty (30) business days after the equipment is installed. Scheduling of final inspections, if applicable, shall be contingent upon the
notification of completion of all essential home improvements and submittal of all required documentation.
3.
All data must be properly recorded and submitted by the technician. NOTE: Incomplete information cannot be processed under the Smart Energy
Existing Homes Program.
4.
The technician must sign this form.
5.
All necessary documents and information must be submitted no later than November 30, 2021.
* Note: Contractors installing Water Heater must have a South Carolina Plumbing Contractor's License.
Step 1
Contractor Information
Contractor Name Installation Technician's Name (print)
Contractor Phone Number Date of Start-Up
South Carolina Plumbing Contractor's License Number
Step 2
Customer Information
Customer Name Customer Phone Number
Street Address City
State
Zip
Electric Meter Number / Meter Base
Step 3
System Information
Equipment Selection Information
Unit
No.
Energy
Factor
Capacity
(Gallons)
Manufacturer
Model
Number
Serial N
umber
1
2
2021 Smart Energy Existing Homes
Heat Pump Water Heater Form
Year House was Built
V2.2021 (3/1/2021)
Page 2 of 2
Equipment Selection Information
Unit
No.
Location of Equipment
Installation Room
Size
(feet)
Installation Clearances Installation Checklist
1
Gara
ge
Attic
Basement
Other (please explain):
Length
x width
x height
=
cu. ft.
Air Inlet Side (ft.)
Air
Outlet
Side
(ft.)
Back (in.)
Front (ft.)
Top (in.)
There is adequate clearance to remove the air filter.
Installation complies with code and manufacturer
specifications.
Condensate line drains at a slope to a drain or exterior.
Temperature and pressure relief valve is properly installed
and not plugged.
Homeowner is aware of cooling effect and noise levels to
expect in installation area.
Homeowner understands maintenance requirements.
Homeowner understands the safety instructions.
2
Gara
ge
Attic
Basement
Other (please explain):
Length
x width
x height
=
cu. ft.
Ai
r
Inlet Side (ft.)
Air
Outlet
Side
(ft.)
Back (in.)
Front (ft.)
Top (in.)
There is adequate clearance to remove the air filter.
Installation complies with code and manufacturer
specifications.
Condensate line drains at a slope to a drain or exterior.
Temperature and pressure relief valve is properly installed
and not plugged.
Homeowner is aware of cooling effect and noise levels to
expect in installation area.
Homeowner understands maintenance requirements.
Homeowner understands the safety instructions.
Step 4
Quality Assurance Agreement
I hereby certify that I am a South Carolina licensed plumbing contractor and have completed the installation or replacement of HVAC equipment in accordance
with the manufacturer's guidelines and Program requirements and have complied with all permitting requirements, as applicable. The information provided in this
form is accurate and complete. I understand that Santee Cooper requires this form to be fully completed and all required documentation submitted in order to
process related loans and/or rebate requests.
Technician Signature and Printed Name Date
Send Completed Form to:
Mail: Santee Cooper Energy Support Services
305A
Gardner Lacy Rd
Myrtle Beach, SC 29579
Email: residential.energy@SanteeCooper.com
Please enter in email subject line – SECURE: Heat Pump Water Heater Rebate
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Form 2.: 2021 Smart Energy Existing Homes Heat (Santee Cooper)

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Completed 22 July 2021

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