Stingray Pipeline Company, L. L. C.

Third Revised Volume No. 1

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Effective Date: 11/01/2008, Docket: RP08-436-000, Status: Effective

Original Sheet No. 339 Original Sheet No. 339

 

FORM OF SERVICE REQUEST FORM

 

Requests for service under Stingray's FERC Gas Tariff shall be deemed valid

only after the following information is provided by Shipper in writing to

Stingray's Transportation Services, at 1100 Louisiana, Suite 3300, Houston,

Texas 77002, or Fax Number (832) 214-5791.

 

Acceptance of a request is contingent upon a satisfactory credit appraisal by

Stingray in accordance with Section 14 of the "General Terms and Conditions"

of its FERC Gas Tariff.

 

Date of Request:

 

Request for Modification of existing Service (circle one) Yes No

 

I. Shipper (Full Legal Name)

State of incorporation:

Type of Service (circle one) FTS FTS-2 ITS PARKING LENDING

(Other type of Service) _

Shipper Address:

_____

Telephone No.: Fax No.:

E-mail address:

Shipper's Federal Tax ID #

Shipper's DUNS #

 

II. Production Platform (Block No.):

 

III. Maximum Daily Quantity (MDQ) Requested: Dth

Dates of Service: Commencing ______________ Ending _____________

 

IV. Receipt Point(s): All or specify

Delivery Point(s): All or specify

 

V. Liquids Transportation Agreement required?

(please circle one): Y (Block No. ) N

 

VI. Stingray Onshore Separation Agreement required

(please circle one): Y N

 

VII. Gas Dehydration Agreement required? (please circle one): Y N