Viking Gas Transmission Company
Original Volume No. 1
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Effective Date: 11/01/1993, Docket: RS92- 52-001, Status: Effective
Original Sheet No. 117 Original Sheet No. 117 : Superseded
CUSTOMER NOMINATION FORM
Viking Gas Transmission Company
P. O. Box 2511
Houston, Texas 77252
(713) 757-1500; (800) 544-6449 (outside Texas)
Telefax: (713) 757-5494
Shipper: _______________________________
Phone No.: _______________________________
Initial Service: _______________________________
Contract No.: _______________________________
Effective Date of Requested Service: ___________
Receipt Point into Viking
Previous New
Volume Receipt Receipt Receipt Receipt
Source Meter Company/ Volume Request Volume Request
Description Number Contract Operator Producer MMBTU MMBTU
__________ ______ ________ ________ ________ ______________ ______________
__________ ______ ________ ________ ________ ______________ ______________
__________ ______ ________ ________ ________ ______________ ______________
__________ ______ ________ ________ ________ ______________ ______________
Total ______________
Viking's Delivery Point
Previous New
Delivery Delivery
Delivery Delivery Less Fuel Less Fuel
Meter Delivery Company/ Phone @ 14.73 Psia @ 14.73 Psia
Number Description Contract Number MMBTU MMBTU
_________ ___________ ________ ________ _____________ ____________
_________ ___________ ________ ________ _____________ ____________
_________ ___________ ________ ________ _____________ ____________
_________ ___________ ________ ________ _____________ ____________
Total ____________