Viking Gas Transmission Company

First Revised Volume No. 1

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Effective Date: 01/01/2000, Docket: RP00-110-000, Status: Effective

Second Revised Sheet No. 111 Second Revised Sheet No. 111 : Superseded

Superseding: First Revised Sheet No. 111

 

SERVICE REQUEST FORM (Continued)

 

Viking Gas Transmission Company

Page 5

 

9. Date service is proposed to commence:

 

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10. Term of service:

 

_____________________________________

 

11. If additional or new facilities are required to receive or deliver

gas for the service requested herein, please provide description of

facilities required, location, and requested in-service date;

 

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and, if the service to be provided using the new facilities is to a

customer that is located in the service area of a local distribution

company, please specify the name of the local distribution company.

 

12. The maximum daily quantity is ___________ Dth. The estimated total

quantity of gas to be transported, parked or loaned during the

requested term of service is ___________ Dth.

 

13. For firm transportation only, the name and description of Point(s)

of Receipt into Viking's system and the maximum daily quantities

expressed in Dth of gas to be delivered by Shipper for each point:

 

__________________________________________________________________

__________________________________________________________________

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(The sum of the maximum daily quantities above must equal the maximum

daily quantity set forth in No. 12 above.)