Arlington Storage Company, LLC

Original Volume No. 1

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Effective Date: 08/24/2009, Docket: RP09-872-000, Status: Effective

Original Sheet No. 160 Original Sheet No. 160

GENERAL TERMS AND CONDITIONS

(Continued)

33.3 Requested Firm Storage Services:

(a) Request Quantities

Maximum Storage Quantity (MSQ) (FSS only) ______

No-Notice Maximum Daily Quantity (NNSS only) ______

Maximum Park Quantity (FP only) ______

Maximum Loan Quantity (FL only) ______

Maximum Daily Injection Quantity (MDIQ) ______

Maximum Daily Withdrawal Quantity (MDWQ) ______

Transporter Name: __________________________________________________________

(b) Rate prospective Customer proposes to pay for storage service under Rate

Schedules FSS, NNSS, FP or FL:

Monthly Storage Reservation Charge (FSS only)

_____________________

Monthly Withdrawal Reservation Charge (FSS only)

_____________________

Monthly Injection Reservation Charge (FSS only)

_____________________

Monthly No-Notice Reservation Charge (NNSS only)

_____________________

Monthly Parking Reservation Charge (FP only)

_____________________

Monthly Loan Reservation Charge (FL only)

_____________________

Injection Charge

_____________________

Withdrawal Charge

_____________________

Excess Injection Charge

_____________________

Excess Withdrawal Charge

_____________________

Fuel Reimbursement

_____________________

(c) Term of Service:

Commencement Date:

_____________________

Termination Date:

_____________________