Valero Interstate Transmission Company

First Revised Volume No. 1

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Effective Date: 11/01/1991, Docket: GT91- 42-000, Status: Effective

Original Sheet No. 96 Original Sheet No. 96 : Superseded

TRANSPORTATION REQUEST FORM

---------------------------

1. (A) DATE OF REQUEST _____________________ TIME ______________

(B) REQUEST RECEIVED BY (NAME) _______________________________

2. * DATE REQUEST ACCEPTED AS VALID _____________

3. REQUESTER (A) NAME _________________________

(B) AFFILIATE (Y/N) ______________

4. SUPPLIER AFFILIATION (Y/N) _________________

5. SHIPPER: (A) NAME __________________________

(B) AFFILIATE (Y/N) _______________

(C) TYPE ___ LDC ___ INTERSTATE P/L

___ INTRASTATE P/L ___ END-USER

___ PRODUCER ___ MARKETER

6. VOLUMES: (A) MAXIMUM DAILY TRANSPORTATION QUANTITY

MCF ___________________

MMBTU ___________________

(B) TOTAL CONTRACT QUANTITY

MCF ___________________

MMBTU ___________________

7. PRODUCING AREA OF SOURCE OF GAS:

(A) STATE __________________________ COUNTY _____________

(B) FIELD NAME ______________________________

8. SERVICE DATES: (A) COMMENCE ____________

(B) TERMINATE ____________

9. RECEIPT/DELIVERY POINT(S):

(A) RECEIPTS POINT(S) ___________________________________

(B) DELIVERY POINT(S) ___________________________________

(C) PIPELINE MILES BETWEEN FURTHEST POINTS _______________

10. TYPE OF SERVICE: ___ FIRM ___ INTERRUPTIBLE

11. LOCATION OF ULTIMATE END-USER (STATE) ____________________________

12. * APPLICABLE RATES TO BE CHARGED:

(A) RATE SCHEDULE ____________ RATE _________________

* PROVIDED BY VITCO