Energy West Development, Inc.

Original Volume No. 1

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Effective Date: 08/10/2007, Docket: RP07-522-000, Status: Effective

First Revised Sheet No. 103 First Revised Sheet No. 103 : Effective

Superseding: Original Sheet No. 103

 

Shoshone Pipeline Gas Transportation Nomination Form*

All Volumes are reported in dekatherms

 

 

Nomination Effective Date: Nomination Effective Time:

Shipper Name: ________________________________________

Contract#: ________________________________________ Submit To: Energy West Development

Shipper ID#: ________________________________________

Contact: ________________________________________ Contact: Brad Samuels

Phone: ________________________________________ Phone: (307) 527-3966

Fax: ________________________________________ Fax: (307) 587-4563

E-Mail Adress: ________________________________________ E-mail Address: bsamuels@ewst.com

 

 

RECEIPTS

 

Receipt Upstream Previous Day DATE

Point Identifier Nomination Volume Nominated Volume Change

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

__________ ____________ _____________________________________________-______

___________________________________________________________________________-______

Total Receipts

 

Less L&U %

 

Available for Delivery_______________________________________________

 

 

 

DELIVERIES

 

Delivery Downstream Previous Day DATE

Point_____ Identifier___ Nomination Volume_ Nominated Volume__ Change__

__________ _____________ __________________ __________________ ________

Pre-determined _____________ __________________ __________________ ________

Allocation _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

__________ _____________ __________________ __________________ ________

_______________________________________________________________________________

Total Deliveries

 

Net Imbalance

Positive # indicated receipt from imbalance

Negative #indicates delivery to imbalance

 

*Please receive, transport and deliver gas under the contract(s) specified as listed

on this form. This nomination will remain in effect until changed.