Equitrans, L. P.
Original Volume No. 1
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Effective Date: 05/16/2010, Docket: RP10-616-000, Status: Effective
Second Revised Sheet No. 502 Second Revised Sheet No. 502
Superseding: First Revised Sheet No. 502
SERVICE REQUEST FORM (Continued)
7. APPALACHIAN PRODUCTION INFORMATION (IF APPLICABLE)
Customer has or will obtain title to the gas quantities requested above
and has entered into or will enter into all arrangements necessary to
ensure all upstream and downstream transportation will be in place prior
to the initiation of service.
A. Has/Have permit(s) been obtained for well(s)? YES NO
B. Is/Are wells drilled? YES NO
Permit Number(s): , ,
C. Location of Well(s) Field(s):
Twp./Dist., County, & State:
D. Topographic Map Designation (USGS 7.5'):
(Please attach 8-1/2" x 11" portion of top sheet showing well(s) location
and any documents which may be helpful in processing this application,
such as description of lease(s), location sketch or plot, permit number,
completion data, farm maps, etc.)
8. CREDIT EVALUATION
Equitrans' acceptance of a request for service is contingent upon the
requesting party's satisfying a credit evaluation by Equitrans.
Please provide the following information:
A. Bank References
B. Year end financial statements together with the latest quarterly
C. A list of all affiliates.
D. A statement of whether the requesting party is operating
under any bankruptcy or insolvency law or any law relating to
the relief of debtors, reorganization or creditors
E. Such other information as Equitrans deems necessary to
evaluate the creditworthiness of the requesting party.
9. PLEASE RETURN THIS COMPLETED APPLICATION TOGETHER WITH THE
INFORMATION REQUESTED IN ITEM 8 ABOVE TO:
c/o Gas Transportation Department
625 Liberty Avenue, Suite 1700
Pittsburgh, PA 15222-3111