Riverside Pipeline Company, L. P.

First Revised Volume No. 1

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Effective Date: 10/01/1993, Docket: RS92- 48-001, Status: Effective

Original Sheet No. 127 Original Sheet No. 127 : Effective

 

 

GENERAL TERMS AND CONDITIONS

APPENDIX A

 

SERVICE REQUEST FORM

(cont'd)

 

15. The identity of:

 

a. Any immediate upstream transporters of the gas to the Point(s) of

Receipt for each Point(s) of Receipt:*

___________________________________________________________

 

b. Any immediate downstream transporters of the gas from the Point(s)

of Redelivery for each Point(s) of Redelivery:*

___________________________________________________________

 

* Please include contract date with any interstate pipeline company

when requesting transportation under Section 284G notice filing.

 

16. Is there an affiliation between Riverside and any of the following

parties to this transaction?

 

Yes No If Yes, Name

 

a) Shipper _____ _____ ___________________________________

b) End User _____ _____ ___________________________________

c) Supplier _____ _____ ___________________________________

d) Other * _____ _____ ___________________________________

 

* Please describe involvement ________________________________

___________________________________________________________