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*Company Name Requesting Service
*Corporate Address
*City
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*Zip/Postal Code
*Project Manager or Primary Contact
*Phone Number
Email Address
Service Location
(Specify address, or if at a development site list Section, Township, and Range)
City
State
Zip/Postal Code
Estimated Volumes/Natural Gas Load
(Specify units in MMBtu per day)
Max Hourly Requirement
Pressure Requirement
(Specify PSI at burner tip or outlet side of meter)
In-service Date For Test Gas
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Facility Start Up Date
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Number of Months Facility Operates Per Year
(If seasonal, indicate months of operation)
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Description of Project Services Available From CNGC
Project Feasibility Study
Confidentiality Agreement
Project Manager
Project Design and Pipe Installation
Facility Maintenance and Repairs
Gas Supply and Energy Management
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