Express 250 Construction Signoff Form

All trenching completed and conduit/ducting laid in place.

The Concrete Mounting Template (CMT) in place with anchor bolts and conduit stub-ups correctly inserted, and the CMT held at the proper height to prevent movement during the concrete pour.

Completed concrete pad showing anchor bolts and conduit stub-ups in place.

Paired only: Conduit stub-ups (or provision for armored cable) in place for DC conductors and Ethernet.

Overall space around the concrete pad, showing all service clearances are available.

The electrical panel‘s specification label, to show total panel capacity.

The open electrical panel with the dead front panel removed, showing terminations.

The open electrical panel with the dead front panel on, showing breaker amperage ratings and labels for Express 250 connections.

Paired only: The front of each AC disconnect (if applicable by region).

The concrete pad was designed and approved by a structural engineer for this specific site, or supports these specifications:

Walls, fences, or slopes do not prevent water from draining from the pad.

The concrete mounting template (CMT) is installed in the concrete pad, 50.8 mm (2 in) below the concrete surface, with anchor bolts in place in the CMT.

The AC conduit (max 50.8 mm/ 2 in trade size) and shunt trip conduit (max 19.1 mm/ ¾ in size) are positioned correctly in the CMT and cut down to 76.2 mm (3 in) above grade.

Paired only: The DC conduit (max 76.2 mm/ 3 in trade size) and Ethernet conduit (max 19.1 mm/ ¾ in size) are positioned correctly in the CMT and cut down to 76.2 mm (3 in) above grade.

The service clearance of open space (not necessarily at system grade) extends a minimum of 610 mm (24 in) beyond the station in front, 1276 mm (50 in) total front to back, 2156 mm (84.8 in) side to side centered on the station, and 305 mm (12 in) above the station.

The front of the station has 352 mm (14 in) of space at grade from the front right anchor, extending 1700 mm (67 in) to the left, without any permanent obstructions (bollards, wheel stops, etc).

Charging station sites are positioned so that each station is centered on a parking space (unless curbside), with the front of the station facing the vehicle.

The charging station is at least 305 mm (12 in) from any wall as its rear clearance. Stations positioned back to back are no closer than 610 mm (24 in) shared clearance.

All signage, parking spot striping, and “EV Electric Vehicle” markings are completed per site drawings and local code.

A correctly rated, dedicated breaker is installed for each Power Block, per this table:

The transformer nameplate shows that wiring is Wye (Y) connected, 3-phase with bonded neutral plus Ground, minimum K factor 4.

Breakers have shunt trip capability to each Power Block if the site drawing calls for shunt trip wiring.

All electrical infrastructure has been completed per local codes and ChargePoint specifications for 3-phase power plus ground, with properly sized copper as defined in the Site Design Guide. (Do not install Neutral.)

Record the AC conductor size, voltage rating, and insulation type: _______________________

Record the DC conductor size, voltage rating, and insulation type: _______________________

Record the 48 VDC conductor size, voltage rating, and insulation type: _______________________

Outdoor rated Ethernet Cat6 STP Shielded Twisted Pair cable, without terminations, is pulled between the two stations with 2 m (6 ft) of service loop at each end.