NorAm Gas Transmission Company

Fourth Revised Volume No. 1

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Effective Date: 08/01/1995, Docket: RP95- 53-000, Status: Effective

1st Rev Original Sheet No. 330 1st Rev Original Sheet No. 330 : Superseded

Superseding: Original Sheet No. 330

Form of Request for Pooling Service





Date Service is to commence ____________________


Rate Schedule SBS option: _____ Yes _____ No

If yes check requested service(s) and specify maximum(s):

____ Advance Receipt Maximum Quantity _____ MMBtu

____ Advance Delivery Maximum Quantity _____ MMBtu


E. Are New/Modified Facilities Required? _____ Yes _____ No. If yes, please describe.


F. Pool Manager must submit a complete credit application in the form provided for in Transporter's

Tariff. Transporter shall have no obligation to accept Pool Manager's request for service or to

perform service if Pool Manager has not qualified under Transporter's credit policies.


G. Unless Pool Manager designates otherwise, Pool Manager's signature below shall constitute its

agreement to execute a Service Agreement as provided in Section 1( c) of Rate Schedule PS and to

comply with the terms and conditions of Transporter's Tariff . Yes____ No____



H. Pool Manager shall provide, in writing, such other information as is required to comply with

regulatory reporting and/or filing requirements and Transporter's Tariff.


Pool Manager or Pool Manager's agent by its signature, certifies to Transporter (1) that it has

good title to the gas or a current contractual right to acquire title or the full right to deliver

all Gas delivered or caused to be delivered, and (2) that it has entered into all necessary

arrangements to assure that upstream and downstream transportation will be in place prior to the

commencement of the requested service.


Pool Manager or Pool Manager's agent also certifies that the information herein is complete and

accurate to the best of Pool Manager's knowledge, information and belief.




By ________________________________________


Title _____________________________________


Signature _________________________________