Blue Lake Gas Storage Company
First Revised Volume No. 1
Contents / Previous / Next / Main Tariff Index
Effective Date: 04/01/2010, Docket: RP10-448-000, Status: Effective
Second Revised Sheet No. 156 Second Revised Sheet No. 156
Superseding: First Revised Sheet No. 156
Blue Lake Gas Storage Company
Storage Service Request Form
Send to: Blue Lake Gas Storage Company ("Seller")
717 Texas Street
Houston, Texas 77002-2761 _____________ Date Received
Attention: Commercial Services
Telecopier No.: (832) 320-5677
Verification: (832) 320-5474
NOTE: A check, if required by Section 2.1 of the General Terms
and Conditions of Seller's FERC Gas Tariff, First Revised
Volume No. 1 ("Tariff"), must accompany each Storage
Service Request to be valid.
INFORMATION REQUIRED FOR VALID STORAGE REQUEST
NOTE: ANY CHANGE IN THE FACTS SET FORTH BELOW, WHETHER BEFORE OR AFTER
SERVICE BEGINS, MUST BE PROMPTLY COMMUNICATED TO SELLER IN
WRITING.
1. Requestor: (Do not complete if same as Customer, see No. 3
below)
Requestor's Name:________________________________________________
2. Is Requestor affiliated with Seller? YES _____ NO_____
If yes, type of affiliation and the percentage of ownership
between Blue Lake and Requestor__________________________________
3. Customer's Name and Address: (Note: The "Customer" is the
party which proposes to execute the Storage Agreement with
Seller).
_________________________________________________________________
_________________________________________________________________
Attention: ______________________ Telephone ( )_______________
Address for ____________________________________________________
Statements ____________________________________________________
& Invoices ____________________________________________________
Attention: ____________________ Telephone ( )_______________
For All ____________________________________________________
Other Matters____________________________________________________
Attention: ____________________ Telephone ( )_______________
Dispatch & Control Representative _______________________________
Telephone No. ( )______________ Telecopier ( )_______________