Energy West Development, Inc.

Original Volume No. 1

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Effective Date: 07/01/2003, Docket: RP03-433-000, Status: Effective

Original Sheet No. 102 Original Sheet No. 102 : Effective

SERVICE REQUEST FORM FOR

ENERGY WEST DEVELOPMENT, INC.

12. This form is provided for the convenience of Shipper in complying with the transportation request procedures

of Transporter's currently effective FERC Gas Tariff. Nevertheless, it is Shipper's responsibility to provide

all of the information necessar

Yours very truly,

(Shipper)

Date:

Internal Use Only

1. Date and Time Request Received

2. Sufficient Data (Y/N)

If no, date letter sent:

3. Agreement Date:

4. Agreement No.:

5. Energy West Development, Inc. Representative: