Energy West Development, Inc.
Original Volume No. 1
Contents / Previous / Next / Main Tariff Index
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.