Granite State Gas Transmission, Inc.

Third Revised Volume No. 1

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Effective Date: 12/13/1993, Docket: RS93- 1-001, Status: Effective

Original Sheet No. 502 Original Sheet No. 502 : Effective

 

 

 

FORM FOR REQUEST FOR TRANSPORTATION SERVICE

(continued)

 

 

(d) The specific affiliation of the requester with Transporter, if

any: ______________________________________.

 

(e) Name of Shipper's contact, address and telephone number

through which correspondence for the following should be

directed:

 

Contact for Request: ____________________________________

____________________________________

____________________________________

____________________________________

 

 

Contact for Notices: ____________________________________

____________________________________

____________________________________

____________________________________

 

 

Contact for Invoices: ____________________________________

____________________________________

____________________________________

____________________________________

 

 

(f) Are additional or new facilities required to receive or deliv-

er gas for the transportation service requested herein?

_______ Yes _______ No.

 

(g) Name and full title of Officer (or General Partner) of Shipper

who will execute written transportation agreement with Trans-

porter.

 

____________________________ ____________________________

Name Title