Scg Pipeline Inc.

Original Volume No. 1

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Effective Date: 11/01/2003, Docket: RP03-611-000, Status: Effective

Original Sheet No.219 Original Sheet No.219 : Superseded





Transportation Services Department



SCG Pipeline, Inc.

P.O. Box 102407

Columbia, SC 29224-2407





To Whom It May Concern:


______________________________ (Shipper) hereby requests transportation

services from SCG Pipeline, Inc. (Pipeline) and is providing Pipeline the

following information in connection with this request:


1. Type of service requested is:

____ new service

____ modification to existing service under

Contract No. __________

____ conversion from existing Section 311 service under

Contact No. ___________

____ to blanket transportation service and:


____ firm transportation (FT) (Code 1)

____ interruptible transportation (IT) (Code 2) under:


____ Section 311 of NGPA (Section 284.101 et seq.)

____ Blanket certificate (Section 284.221 et seq.)




2. Full legal name of Shipper, type of legal entity and, if corporation

state of incorporation:






Contact person, address, email address and telephone number for Shipper in

areas of responsibility shown below, a 24-hour telephone number, three contact

persons for Shipper for emergencies, email addresses and a facsimile machine

number (if available):