Equitrans, L. P.

Original Volume No. 1

 Contents / Previous / Next / Main Tariff Index

 

 

Effective Date: 05/16/2010, Docket: RP10-616-000, Status: Effective

Fourth Revised Sheet No. 500 Fourth Revised Sheet No. 500

Superseding: Third Revised Sheet No. 500

 

EQUITRANS, L.P.

625 Liberty Avenue, Suite 1700

Pittsburgh, PA 15222-3111

 

SERVICE REQUEST FORM

 

1. TYPE OF SERVICE REQUESTED (please check one):

 

____ITS ____NOFT ____FTS ____115SS ____60SS

 

____INSS ____LPS

 

2. REQUESTOR'S IDENTIFICATION:

 

Company Name: ______________________________

 

______________________________

 

Address: ______________________________

 

______________________________

 

______________________________

 

 

Contact Person: ______________________ Telephone: _________________

 

E-Mail Address :______________________

 

Dun & Bradstreet No.: _____________________

 

Billing Address (if different from above):

 

______________________________

 

______________________________

 

Contact Person to receive invoices: ________________________________

 

E-Mail Address : ________________________________

 

3. CUSTOMER'S IDENTIFICATION (if different from above):

 

Company Name: ______________________________

 

______________________________

 

Address: ______________________________

 

______________________________