Western Gas Interstate Company

Third Revised Volume No. 1

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Effective Date: 06/01/1993, Docket: RS92- 53-003, Status: Effective

Revised Original Sheet No. 403 Revised Original Sheet No. 403 : Superseded

 

 

TRANSPORTATION REQUEST FORM

(continued)

 

 

6. If shipper is requesting service be performed by Western for

 

Shipper acting as agent for another entity, please specify the

 

full legal name and address of such entity.

 

__________________________________________________

 

__________________________________________________

 

__________________________________________________

 

__________________________________________________

 

 

 

7.* The intended use of the gas is:

 

________ system supply

________ end use by industry or commerce

________ other (fill in)

 

_____________________________________________

 

 

8. Date service is proposed to commence:

 

________________________________

 

 

9. Expiration Date:

 

________________________________