American Midstream (Midla), LLC

Sixth Revised Volume No. 1

 Contents / Previous / Next / Main Tariff Index

 

 

Effective Date: 05/01/2010, Docket: RP10-483-000, Status: Effective

Original Sheet No. 366 Original Sheet No. 366

 

6. If the service requested is ?on behalf? of a 311 entity, please complete the

following as it pertains to the 311 Party:

 

Name:____________________________________________________________

____

 

Address:__________________________________________________________

___

_____________________________________________________________

Telephone

Number:___________________________________________________

 

311 Party Status: _____ Hinshaw _____ LDC _____ Interstate

 

Location (by State) of 311 Party's Facilities:_________________________

 

(Pipeline reserves the right to require proof that Customer's request meets the

requirements of the applicable Commission Regulations)

 

7. If Customer is not a local distribution company and is requesting service be

performed by Pipeline for Customer acting as agent for another entity, please specify the

full legal name of such entity.

__________________________________________________________________

_____

 

8. Date service is proposed to

commence:__________________________________

 

9. Maximum Daily Transportation Quantity (MMBtu/Day):_____________________

 

10. Term of service: years months

 

11. Transportation Rate Requested:

 

Demand $ _____________

Commodity $ _____________

 

12. Identity of Upstream and Downstream Pipelines involved in the transaction:

Upstream: __________________________________________________

Downstream: __________________________________________________

 

13. Midla Receipt Point(s): ______________________________________

 

14. Midla Delivery Point(s):______________________________________

(if request is for firm transportation service, the sum of these maximum quantities must

equal the maximum transportation quantity in #9 above.)

 

15. If additional or new facilities are required to receive or deliver gas for the

transportation service requested herein, please provide description of facilities required,

location, and requested in-service date.

__________________________________________________________________

_____

__________________________________________________________________

_____

__________________________________________________________________

_____