Pipeline Safety Forms

All PDF forms, unless otherwise indicated, are created using Adobe Acrobat. To view the files you need to have the Adobe Acrobat Reader version 6.0 or higher, available free from Adobe.

PDF	Fillable PDF

General Pipeline Forms

Form Number	Form Name	PDF Form	Fillable PDF
PS-86A	Texas School Facilities Gas Pipe Testing
PS-86B	Texas School Facilities Gas Pipe Test Results
PS-95	Semi-Annual Leak Report
PS-95	EDI Specification
N/A	Master Meter Evaluation
N/A	Hazardous Liquid Evaluation
N/A	Gas Transmission Evaluation
N/A	Gas Distribution Evaluation
N/A	Pipeline Company/Unit/System Data

Pipeline Permitting Forms

Form Number	Form Name	PDF Form	Instructions:	Fillable PDF
T-4B	Pipeline Transfer Certification (File with T-4)
	Non-Utility Certificate
	Guidance for Natural Gas Operators/Economic Operators
PS-48	New Construction Report (Updated June 2020)

Sample Cover Letters

• Amendment
• Inactivate
• Merge Permits and Inactivate
• New Permit - New Lines
• New Permit - Transferred Lines - Acquiring Operator
• Partial Transfer - Acquiring Operator with Additional Amendments
• Partial Transfer - Divesting Operator
• Renewal
• Total Transfer - Divesting Operator
• Total Transfer Keep Active - Acquiring Operator with Additional Amends
• Total Transfer Keep Active - Acquiring Operator without Additional Amends
• Total Transfer Merge and Inactivate - Acquiring Operator

Sample Overview Maps

• Overview Map Example Multiple Counties
• Overview Map Examples 1-2 Counties
• Renewal Overview Map

Pipeline Map Request Form

Form Number	Form Name	PDF Form
N/A	Pipeline Map Request