Load Upgrade Request

Customer Information
Date:*
MM slash DD slash YYYY
Customer/ Account Name:*
Service Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number:*
Email
Reason for load sheet:*
Residential Large Load (new build or conversion) & Gas Load Upgrade (exisiting customers)
- Residential Large Load
- Gas Load Upgrade
Residential Large Load
** above 275,000 BTU **
This is a:*
- New Construction
- Conversion
Total Connected Gas Load:*

(specify B.T.U. or M.B.H.)
Outlet Pressure Needed:*
(Specify WC" or PSI)
Gas Load Upgrade
** If the current gas load is increasing **
Current Load*
Upgraded Load:*
New total on both Loads (Current+Upgrade):*
Outlet Pressure Needed:*
(Specify WC" or PSI)
I understand that all costs associated with upgrades are the responsibility of the person who signs this form.*
Yes, I understand
Electronic Signature*
First Last

Customer Information