Equitrans, L. P.
Original Volume No. 1
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Effective Date: 05/16/2010, Docket: RP10-616-000, Status: Effective
First Revised Sheet No. 501 First Revised Sheet No. 501
Superseding: Original Sheet No. 501
SERVICE REQUEST FORM (Continued)
Contact Person: ______________________ Telephone: _________________
4. TRANSPORTATION SERVICE:
TOTAL MAXIMUM DAILY QUANTITY REQUESTED WINTER: _________________DTH
TOTAL MAXIMUM DAILY QUANTITY REQUESTED BASE : _________________DTH
STORAGE SERVICE:
MAXIMUM DAILY INJECTION QUANTITY REQUESTED : _________________DTH
MAXIMUM DAILY WITHDRAWAL QUANTITY REQUESTED: _________________DTH
TOTAL ANNUAL STORAGE QUANTITY REQUESTED : _________________DTH
5. PRIMARY RECEIPT AND DELIVERY POINT(S) REQUESTED
ALL REQUESTORS: FOR LOCATION DESCRIPTION, PLEASE BE AS SPECIFIC AS
POSSIBLE.
A. Customer request to deliver into Equitrans' pipeline at the following
receipt points:
Measuring Station No. Location Description (DTH) MDQ
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
B. Customer requests to the following points for delivery by Equitrans:
Measuring Station No. Location Description (DTH) MDQ
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
_____________________ ____________________________ ______________
6. REQUESTED TERM OF SERVICE
Commencement Date: Termination Date: