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) _
Telephone No.: Fax No.:
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