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.