PART 2. SUBMISSION INFORMATION

2 0

176

EIA-176

Ben Franklin Station

Address 2:

City: State: Zip: -

Distribution company - investor owned Storage operator 

Distribution company - municipally owned Synthetic natural gas (SNG) plant operator

Distribution company - privately owned Producer

Distribution company - cooperative

Distribution company - other ownership

Interstate pipeline (FERC regulated)

Intrastate pipeline

B. Vehicles Powered by Alternative Fuels

Does your company's vehicle fleet include vehicles powered by alternative fuels? No

D. Sales/Acquisitions

No

or sale this year? If Yes, please describe the sale or acquisition in the Comments box below.

Page 1

C. Customer Choice Program

If there is a Customer Choice program available in your service territory, enter the number Eligible Participating

Comments: (To separate one comment from another, press ALT+ENTER)

the end of the calendar year.

Questions?

Secure File Transfer:

Address 1:

If yes, how many vehicles in your company's fleet are powered by alternative fuels?

Liquefied natural gas (LNG) peak facility operator

14. Other (specify)

2.

A completed form must be filed by March 1

Mail to:

Form may be submitted using one of the following methods:

1. Yes

PART 1. RESPONDENT IDENTIFICATION DATA

Company Name:

Year:

If this is a resubmission, enter an "X" in the box:

EIA ID NUMBER:

If any Respondent Identification Data has changed since the last report, 

Fax No.:

Contact Name:

Phone No.: Fax:

ANNUAL REPORT OF NATURAL AND SUPPLEMENTAL GAS SUPPLY & DISPOSITION

FORM EIA-176

OMB No. 1905-0175

Expiration Date: 02/28/2015

Version No.: 2012.01

Operations in (State): 

REPORT PERIOD:

This report is mandatory under the Federal Energy Administration Act of 1974 (Public Law 93-275). Failure to comply may result in criminal fines, civil penalties and

other sanctions as provided by law. For the sanctions and the provisions concerning the confidentiality of information submitted on this form, see instructions. Title 18 

USC 1001 makes it a criminal offense for any person knowingly and willingly to make to any Agency or Department of the United States any false, fictitious,

or fraudulent statements as to any matter within its jurisdiction.

U. S. Department of Energy

Email:

Ext:

Oil & Gas Survey

Washington, DC 20044-0279

P.O. Box 279

enter an "X" in the box:

OOG.SURVEYS@eia.gov

11.

(202) 586-1076

1. Did your distribution territory increase or decrease in size in the reportState due to acquisition Yes

of customers currently eligible for and participating in the Customer Choice program at 

Residential Residential

7.

12.

6. 13.

2.

3.

(877) 800-5261

Commercial Commercial

Liquefied natural gas (LNG) marine terminal

4. Gatherer

5.

https://signon.eia.doe.gov/upload/noticeoog.jsp

9.

10.

PART 3. COMPANY CHARACTERISTICS

A. Type of Operations (check all that apply)

 1. 8.

Email address:

Call:

Burden: 12.0 hours
REPORT PERIOD: Year: 2 0 COMPANY NAME: Resubmission

EIA ID NUMBER: 176

If you are a producer, report production within the report State of:

line 15.0) ..................

Synthetic natural gas (SNG)

If you are a storage operator, report operations within the report State of:

Underground storage withdrawals

Liquefied natural gas (LNG) storage withdrawals (peaking facilities only)

Above ground storage withdrawals

If you are an interstate pipeline company or other company receiving physical custody at State

lines or U.S. borders, report receipts

From Company 1 1 In neighboring State or Country 1 1

From Company 1 1 In neighboring State or Country 1 1

From Company 1 1 In neighboring State or Country 1 1

From Company 1 1 In neighboring State or Country 1 1

If you are a distributor, report receipts at city gates within the report State ...

Supplemental gaseous fuels supplies (Specify type) 1 1

1 1

Total supply within report State (sum of all items in lines 1.0 through 6.0) .....

If you operate a LNG facility, report LNG inventory as of December 31 of the report year

*Check E if data reported are an estimate; check F if you are providing a footnote in Part 7 for this data item.

**If reporting Natural Gas Production (1.1), data should also be reported on lease use (15.0).

Page 2

OMB No. 1905-0175

(Mcf @ 14.73 

psia and 60o

 F)

Report any other receipts of natural gas within the report State (excluding Federal Offshore) .. .........

3.0

4.0

5.0

6.0

PART 4. NATURAL AND SUPPLEMENTAL GAS SUPPLY FOR THE REPORT STATE

2.0

2.1

2.2

NOTES*

E F

7.0

................................................................................

.............................

................

PART 5. LIQUEFIED NATURAL GAS (LNG) STORAGE INVENTORY

8.0

1.2

.............................................................................................

........................................................................................

2.3

.............................

Natural gas** (if reporting natural gas production, lease use data should also be reported on 

.................................

................................................................................

............................................................................

Expiration Date: 02/28/2015

ITEM DESCRIPTION

VOLUME

1.0

ANNUAL REPORT OF NATURAL AND SUPPLEMENTAL GAS SUPPLY & DISPOSITION

FORM EIA-176

Version No.: 2012.01

1.1
REPORT PERIOD: Year: 2 0 COMPANY NAME: Resubmission

EIA ID NUMBER: 176

Heat content of gas delivered to consumers (Btu/cf)

within the report State (for assistance in determining proper

categorization of customers, see page 3 of instructions)

Residential

Commercial

Industrial

Electric power

Vehicle fuel

Other (not included in above categories)

categorization of customers, see page 3 of instructions)

Residential

Commercial

Industrial

Electric power

Vehicle fuel

Other (not included in above categories)

*Check E if data reported are an estimate; check F if you are providing a footnote in Part 7 for this data item.

Page 3

10.3

10.4

10.6 

10.2

10.5

...............................................................

OMB No. 1905-0175

PART 6. NATURAL AND SUPPLEMENTAL GAS DISPOSITION FOR THE REPORT STATE

NOTES*

E F

10.0

...................................................................

...................................................................

10.1

Deliveries of natural gas that you do own to end-use consumers 

...................................................................

...................................................................

11.1

11.2

11.3

11.4

...................................................................

 ......................................................................

..............................................................

...................................................................

(Specify type)

11.5 ..................................................................

11.6 

11.0 Deliveries of natural gas that you do not own to end-use consumers

Expiration Date: 02/28/2015

ANNUAL REPORT OF NATURAL AND SUPPLEMENTAL GAS SUPPLY & DISPOSITION

FORM EIA-176

Version No.: 2012.01

NUMBER OF 

CUSTOMERS ITEM DESCRIPTION

REVENUE 

(including taxes)

(whole dollars)

VOLUME

(Mcf @ 14.73 

psia and 60o

 F)

9.0

within the report State (for assistance in determining proper

(Specify type)
REPORT PERIOD: Year: 2 0 COMPANY NAME: Resubmission

EIA ID NUMBER: 176

Natural gas consumed in your operations:

Space heat of your facilities

New pipeline fill

Other (Specify type): 1

If you are a storage operator, report operations within the State:

Underground storage injections (including new fields)

Liquefied natural gas (LNG) storage injections (peaking facilities only)

Above ground storage injections

If you are an interstate pipeline company or other company moving gas across or to State lines or

U.S. borders, report volumes transported. (See instructions if additional lines are needed.)

To Company In neighboring State or Country 1 1

To Company In neighboring State or Country 1 1

To Company In neighboring State or Country 1 1

To Company In neighboring State or Country

Lease use (reported by producers only)

Returned to oil and/or gas reservoirs, used for repressuring, reinjection (reported by producers only)

Other disposition within the report State (not included above):

To distribution companies

To other pipelines in the report State

To storage operators in the report State

To other (specify type)

Total disposition (sum of all items 10.1 through 18.4)

Difference between gas supply (+) and disposition (-) (Part 4 line 7.0 minus Part 6 line 19.0)

(this value may be a negative number)

*Check E if data reported are an estimate; check F if you are providing a footnote in Part 7 for this data item.

Page 4

OMB No. 1905-0175

ITEM DESCRIPTION

18.0

17.0

15.0

12.0

12.1

12.2

12.3

12.4

...............................................................................

Losses from leaks, damage, accidents, migration and/or blow down within the report State: ............

........................................................................................

18.4

18.2

.......................................................................

18.1

........................

...........................................................................

........................

VOLUME

F

(Mcf @ 14.73 

psia and 60o

 F)

............................

........................................................................................

Pipeline distribution or storage compressor use ..............................................................

 ........................................................................................................

Version No.: 2012.01

13.0

13.1

13.2

PART 6. NATURAL AND SUPPLEMENTAL GAS DISPOSITION FOR THE REPORT STATE (continued)

ANNUAL REPORT OF NATURAL AND SUPPLEMENTAL GAS SUPPLY & DISPOSITION

FORM EIA-176

NOTES*

E

14.0

16.0

18.3

.............................

......................................................

............................

...............................................................................

19.0

13.3

20.0

........................

Expiration Date: 02/28/2015
REPORT PERIOD: Year: 2 0 COMPANY NAME: Resubmission

EIA ID NUMBER: 176

Page 5

OMB No. 1905-0175

Version No.: 2012.01

ANNUAL REPORT OF NATURAL AND SUPPLEMENTAL GAS SUPPLY & DISPOSITION

FORM EIA-176

PART 7. FOOTNOTES

Footnote

Part

No.

Item

No.

Expiration Date: 02/28/2015