U S G Pipeline Company

ORIGINAL VOLUME NO. 1

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Effective Date: 04/01/2000, Docket: CP99-211-001, Status: Effective

Original Sheet No. 95 Original Sheet No. 95 : Effective

 

SERVICE REQUEST FORM

 

6. The intended use of the gas is:

 

_______________________ system supply for _____________

_______________________ end use by industry of commerce

_______________________ other (fill in)

 

and, if the gas is for other than system supply, provide the full legal

name of the ultimate consumer, the location (i.e., state) of the ultimate

delivery point of the gas to be transported (i.e., if ultimate consumer is

an end use, location(s) of plant(s) where gas is to be consumed) and

indicate the identity of the on behalf of entity corresponding to each

delivery point in paragraph 13 herein:

__________________________________________________________________________________________

 

7. Date service is proposed to commence:

 

_____________________________________

 

8. Term of service:

 

_____________________________________

 

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

gas pursuant to this Request or otherwise perform the requested

service, provide a description of facilities required, location and

requested in-service date 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, specify the name of the local

distribution company.

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

 

10. The:

 

___ Transportation Quantity (sum of MDQs at all Delivery Points under

an FT Agreement) to be transported is ________ Dth per day.

 

___ The Maximum Interruptible Quantity (sum of the maximum quantities

at all Delivery Points under an IT Agreement) to be transported is _______ Dth

per day.