High Island Offshore System, L.L.C.

Third Revised Volume No. 1

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Effective Date: 12/15/2007, Docket: RP08- 65-000, Status: Effective

Third Revised Sheet No. 175 Third Revised Sheet No. 175 : Effective

Superseding: Second Revised Sheet No. 175

HIGH ISLAND OFFSHORE SYSTEM, L.L.C.

PREDETERMINED ALLOCATION FORM

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Date: MO/DY/YR

Recipient Name: ___________________________________________ Time: 00:00:00

Recipient ID #: ___________________________________________ Page _____ of _____

 

Preparer Name: _____________________________________________ Beginning Flow Date:____________ Time: ____________

Preparer ID #: _____________________________________________ Ending Flow Date: ____________ Time: ____________

Preparer Address: __________________________________________

Location Code/Measurement Site: ____________________________ Direction of Flow: _______________

 

 

ALWAYS FACSIMILE PDA REQUEST FORM TO THE FOLLOWING LOCATION:

 

High Island Offshore System, L.L.C.

P. O. Box 4324

Houston, Texas 77210-4324

Attn: Manager, Contract Administration

Facsimile No.: (713) 381-7996

Telephone No.: (713) 381-7940

 

Service Service Percentage Percentage

Allocation Request Requester or Overage or Underage

Method ID Shipper Name Contract Rank Rank

 

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___ Rank ------------ ---------------------------------- -------------- -------------- -------------

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___ Percentage ------------ ---------------------------------- -------------- -------------- -------------

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Contact Person: _________________________________________ Telephone No.: _______________________________

 

____________________________________ Date:_______________ Facsimile No.: _______________________________

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