Request for Non-Residential Gas Service

Project Information

Project Location (Required)
City (Required)
Cross Streets
County
Zip Code (Required)

Application Information

(* Either a Social Security # or Tax ID # is REQUIRED due to ratepayer funded allowance credit requirements)

Responsible Party (As it should appear on the Contract) (Required)
* Social Security# (xxx-xx-xxxx)
* Tax ID
-
Day phone (w/Area Code)
( ) - -
Street Address (Include Apt/Suite, or Bldg Info - No P.O. Box)
City
State
Zip Code
Parent Company Name (if applicable)
Mailing Address (if different from street address)
City
State
Zip Code
Contact Name & Title (if different from applicant)
Day phone (w/Area Code)
( ) - -
Fax (w/Area Code)
( ) - -
Email Address of Responsible Party for Contract Delivery (Required)
Mobile phone 1 (w/Area Code)
( ) - -
Mobile phone 2 (w/Area Code)
( ) - -

Construction Contacts

(if different than Applicant such as Utility Consultants and/or Construction Trench Provider)

Name Title Email Address Day phone (w/Area Code) Mobile phone (w/Area Code)
( ) - - ( ) - -
( ) - - ( ) - -

Project Timeline

Requested Gas Facility (pipe, meter manifold, etc.) Installation Date (Required) Requested Meter To Be Set and Turned On Date
/ / (mm/dd/yyyy) / / (mm/dd/yyyy)

Construction Information

Gas Installation Requested Construction Type Installation Method
Gas Line to Structure w/Meter(s)
Meter(s) Only
New
Existing (acct#)
Gas Company Provided Gas Only Trench
Applicant Provided Gas Only Trench
Applicant Provided Joint Trench

Load Information

(Please list all gas equipment and load - Each meter requires a separate form to determine meter size)

New | Existing Equipment Equipment Function Quantity Equip Input
per Unit
MBTU/Hr
Equipment Operation Schedule Alt. Fuel Type?
Hrs/Day Days/Wk Wk/Year
Example - Boiler Space Heating 1 2500 6 5 24 Propane
Gas Pressure Requested:

Standard (8" Water Column)
Elevated Pressure
Please provide information on: Applicant Design

Applicant Installation Options

Applicant Install - Rule 20 section G allows the applicant to receive a competitive gas installation bid, if desired. If the AI bid option is selected, a gas line extension may be installed by the Applicant's SoCalGas certified and approved Installer and installed per SoCalGas design and installation specifications.

If selected, the Applicant is responsible for, but not limited to, all applicable permits, paving, trenching, approved material, and SoCalGas inspection. SoCalGas does not refer or recommend Applicant Installer's to Applicants due to anti-competitive preferential treatment rules.

Please Select One (Required) : Option 1 - SoCalGas Install       Option 2 - Request Applicant Install Competitive Bid Information

Application Submitted By: Title: Date: / / (mm/dd/yyyy)

Please provide an email address to receive a copy of the request: