Williston Basin Interstate Pipeline Co.

Second Revised Volume No. 1

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Effective Date: 11/01/2002, Docket: RP00-463-004, Status: Effective

Original Sheet No. 386 Original Sheet No. 386 : Effective

 

GENERAL TERMS AND CONDITIONS (Continued)

 

50.8 Segmentation Request Form

 

FROM: Name: _____________________________________________________

Company: __________________________________________________

Telephone No.: _____________________________________________

Facsimile No.: _____________________________________________

Email Address: ____________________________________________

 

TO: Williston Basin Interstate Pipeline Company

Attention: Contracts

Facsimile No: (701) 530-1698

 

1) Shipper requests the following Segmentation of Service:

 

Transportation Contract No. _________________________________

Effective Date of Segmentation: _____________________________

Termination Date of Segmentation: ___________________________

(If different than contract termination date)

 

Primary Receipt Point Primary Delivery Point MDDQ

Point # Description Point # Description (eqv. dkt/d)

------- ----------- ------- ----------- -----------

 

 

Segmented Receipt Point Segmented Delivery Point MDDQ *

Point # Description Point # Description (eqv. dkt/d)

------- ----------- ------- ------------ -----------

 

 

*Requested quantities in total must be equal to or less than Shipper's

MDDQ for the primary receipt and/or delivery point(s) on the effective

request date of segmentation.

 

 

2) Will you accept approval of individually segmented receipt and

delivery point combinations: []Yes []No

 

3) Will you accept lesser quantities: []Yes []No

Disapproval to be designated above by Transporter denoted by an X.

 

Requested by: ________________________ Date: __________________

 

Title: ______________________________

 

Confirmation of segmented request by Transporter:

 

By: __________________________________ Date: ___________________