EV Charger Install Work Sheet

First Name *

Last Name *

Street Address *

Address Line 2

City *

State

Zip Code *

Phone Number *

Email Address *

Have you received your charger? *

Would you like us to provide your Wall charger *

Charger Type *

Make/Model of Vehicle

Type of Home *

Location of your Main Electrical Panel *

Desired location of Charger *

Garage Size (1,2,3 Cars) *

Distance of charger from Electrical Panel in feet *

Will your wall charger be on the same wall as your Electrical Panel? *

What is the size of your main Breaker? It will be listed the main breaker

How many electrical panels does your home have? *

Type of Water Heater *

Would you like a price for surge protection for your Car and Home while we are on site? *

Name of your power provider? *

Picture uploads for load Calculations

Close picture of Main breaker Electrical Panel (example on right) *

Picture of desired location of the charger (example is on the right) *

Picture of main panel from 10 to 15 ft. away (example on right) *