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<br />CITY OF LA PORTE, TEXAS <br />PIPELINE PERMIT ApPLICATION <br /> <br />..... ............... ..... ......... .....INFORMATION ON OWNER AND ApPLICANT ................................. ............ <br /> <br />Phone and Fax <br /> <br /> <br />Company <br /> <br />Company <br /> <br />Person Submitting <br /> <br />Title of Person Submitting Application: <br /> <br />/. <br />'\ I 'I;' I /fi ,Ii <br /> <br />Phone and Fax Number: <br /> <br />. . ' <br />'J' <br /> <br />~. / / <br /> <br />I <br />" I", I <br />, <br /> <br />l,i/iLI! 'I' Email:, <br /> <br />\ , <br />,it i\,,! ji' <br />, <br /> <br />li.<< .' " j I <br />I, <br /> <br />Acting for Owner <br /> <br /> <br />Principal Contact for Submittal Information: <br /> <br />"1 <br /> <br />'f j<' 'J <br /> <br />Title of Principal Contact: <br /> <br /> <br />Phone and Fax Number: , i <br /> <br />t! /'" <br /> <br />)':;' '-lJ.~f <br /> <br />i J ' <br />I H', <br />. <br />i <br /> <br />,,,' <br />'I C""_ <br /> <br />. \ .(",__- _.' ,i, <br />',:,/'I .Emall: .ll..n llf ("I' '~i ,\nl Jr" <br />f ! \ <br /> <br /> <br />..........................INFORMATlON ON TWENTY.FoUR HOUR EMERGENCY CONTACTS.......................... <br /> <br />Twenty.Four Hour Emergency Contact: <br /> <br /> <br />Title of Twenty-Four Hour Emergency Contact: <br /> <br />I ./ <br /> <br />" ,t '11 <br /> <br />Email: <br /> <br />Phone and Fax Number: <br /> <br />Other Numbers for Emergency Contact (pager, cellular, etc,): <br /> <br />Alternate Twenty-Four Hour Emergency Contact" <br /> <br />, i f ~- i i ,t :', <br /> <br />:~ ,\ :,.-" <br /> <br />Title of Alternate Twenty-Four Hour Emergency Contact: <br /> <br />Phone and Fax Number: <br /> <br />!// <br /> <br />t .'.~ <br />f ~ , <br /> <br />Email: <br /> <br />Other Numbers for Alternate Contact (pager, cellular, etc,): <br /> <br />. ..... ... ... .... ...... ........ .... ...... ... ...BASIC INFORMATION ON PiPELINE............... ................ ................... <br /> <br />Size in Diameter: <br /> <br />Commodity(s): <br /> <br /> <br />Origin Point <br /> <br />" .A ' <br /> <br />i <br />i <br /> <br />Destination Point: <br /> <br />il" <br /> <br />, J,' -~ /(-<: f r i <br /> <br />1 ,,1,,1 --} <br /> <br />I . 1 I l <br /> <br />, -1/ <br /> <br />Normal Operating Pressure: <br /> <br />Maximum Operating Pressure: <br /> <br />i, <br /> <br />/ ' <br /> <br />Maximum Allowable Temperature (if applicable): <br /> <br />~.ev7' z.... <br />