Scg Pipeline Inc.

Original Volume No. 1

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Effective Date: 11/01/2003, Docket: RP03-611-000, Status: Effective

Original Sheet No.224 Original Sheet No.224 : Superseded

Attachment A

Transportation Request Form

Receipt Point Information

Shipper: ___________________________________

Maximum

Daily

Receipt

Quantity (Dt) Facilities

Point exclusive Upstream

Operator &

Code Point Name Point Description of FRQ

Pipeline 24-Hour Phone

____ _________ _________________ _______

___________ _____________