Borrower Designation ____

Date Prepared ____

Ratings on form are:

0: Unsatisfactory—no records

1: Unsatisfactory—corrective action needed

2: Acceptable, but should be improved—see attached recommendations

3: Satisfactory—no additional action required at this time

N/A: Not applicable

PART I—TRANSMISSION and DISTRIBUTION FACILITIES

1. Substations (Transmission and Distribution)

a. Safety, Clearance, Code Compliance—Rating: ____

b. Physical Condition: Structure, Major Equipment, Appearance—

Rating: ____

c. Inspection Records Each Substation—Rating: ____

d. Oil Spill Prevention—Rating: ____

2. Transmission Lines

a. Right-of-Way: Clearing, Erosion, Appearance, Intrusions—

Rating: ____

b. Physical Condition: Structure, Conductor, Guying—Rating: ____

c. Inspection Program and Records—Rating: ____

3. Distribution Lines—Overhead

a. Inspection Program and Records—Rating: ____

b. Compliance with Safety Codes: Clearances—Rating: ____

Compliance with Safety Codes: Foreign Structures—Rating: ____

Compliance with Safety Codes: Attachments—Rating: ____

c. Observed Physical Condition from Field Checking: Right-of-Way—Rating: ____

Observed Physical Condition from Field Checking: Other—Rating: ____

4. Distribution—Underground Cable

a. Grounding and Corrosion Control—Rating: ____

b. Surface Grading, Appearance—

Rating: ____

c. Riser Poles: Hazards, Guying, Condition—Rating: ____

5. Distribution Line Equipment: Conditions and Records

a. Voltage Regulators—Rating: ____

b. Sectionalizing Equipment—

Rating: ____

c. Distribution Transformers—

Rating: ____

d. Pad Mounted Equipment—Safety: Locking, Dead Front, Barriers—Rating: ____

Pad Mounted Equipment—Appearance: Settlement, Condition—Rating: ____

e. Kilowatt-hour and Demand Meter Reading and Testing—Rating: ____

PART II—OPERATION AND MAINTENANCE

6. Line Maintenance and Work Order Procedures

a. Work Planning and Scheduling—

Rating: ____

b. Work Backlogs: Right-of-Way Maintenance—Rating: ____

Work Backlogs: Poles—Rating: ____

Work Backlogs: Retirement of Idle Services—Rating: ____

Work Backlogs: Other—Rating: ____

7. Service Interruptions

a. Average Annual Hours/Consumer by Cause (Complete for each of the previous 5 years)

1. Power Supplier ____

2. Major Storm ____

3. Scheduled ____

4. All Other ____

5. Total ____

Rating: ____

b. Emergency Restoration Plan—Rating:____

8. Power Quality

General Freedom from Complaints—Rating:____

9. Loading and Load Balance

a. Distribution Transformer Loading—Rating:____

b. Load Control Apparatus—Rating:____

c. Substation and Feeder Loading—Rating:____

10. Maps and Plant Records

a. Operating Maps: Accurate and Up-to-Date—Rating:____

b. Circuit Diagrams—Rating:____

c. Staking Sheets—Rating:____

PART III—ENGINEERING

11. System Load Conditions and Losses

a. Annual System Loses, ____%—Rating:____

b. Annual Load Factor, ____%—Rating:____

c. Power Factor at Monthly Peak, ____%—Rating:____

d. Ratio of Individual Substation Peak kW to kVA, ____—Rating:____

12. Voltage Conditions

a. Voltage Surveys—Rating:____

b. Substation Transformer Output Voltage Spread—Rating:____

13. Load Studies and Planning

a. Long Range Engineering Plan—Rating:____

b. Construction Work Plan—Rating:____

c. Sectionalizing Study—Rating:____

d. Load Data for Engineering Studies—Rating:____

e. Load Forecasting Data—Rating:____

f. Energy Efficiency and Conservation Program quality assurance compliance—Rating:___

PART IV—OPERATION AND MAINTENANCE BUDGETS

For Previous 2 Years:

Normal Operation—Actual $____

Normal Maintenance—Actual $____

Total—Actual $____

For Present Year:

Normal Operation—Budget $____

Normal Maintenance—Budget $____

Total—Budget $____

For Future 3 Years:

Normal Operation—Budget $____

Normal Maintenance—Budget $____

Additional (Deferred) Maintenance—Budget $____

Total—Budget $____

14. Budgeting:

Adequacy of Budgets For Needed Work—Rating:____

15. Date Budget Discussed with Board of Directors ____

Remarks: ____

EXPLANATORY NOTES

Item No. ____ Comments ____

Rated by ____ ____ Title ____ Date ____

Reviewed by ____ Manager ____ Date ____

Reviewed by ____ RUS GFR ____ Date ____

[63 FR 3450, Jan. 23, 1998, as amended at 78 FR 73371, Dec. 5, 2013; 84 FR 32618, July 9, 2019]