EIA-64A Mock Form

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																																						OMB No. 1905-0057
																																						Expiration Date: 5/31/20YY
																																						Version No: 20YY.01
																																								Burden: 6 hours
ANNUAL REPORT OF THE ORIGIN OF NATURAL GAS LIQUIDS PRODUCTION
FORM EIA-64A
REPORT YEAR 20XX
This report is mandatory under 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 confidentality of information submitted on this form, see the 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.
Questions? Call the EIA-64A Coordinator																			1-800-879-1470							between 9:00 a.m. and 4:30 p.m. Eastern Time
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PART 1.0 PLANT INFORMATION
1.1 Submission Status:												Original						Amended
1.2 EIA ID NUMBER:																				Plant Name:																		Plant Location:
1.3 Operating Co. Name:
1.4 Contact Name:																							Phone No.:																			Ext:
	Email Address:
																									Is the contact information correct? Type Y for Yes or N for No
	Did the plant operate for the entire year? Type Y for Yes or N for No																												If no, then months covered:												through					2017
PART 2.0 SIMPLIFIED DIAGRAM OF A NATURAL GAS PLANT PROCESS
		Inputs												Processing																			Outputs
																																									To Pipeline
		Area of Origin 1																															Outlet Natural Gas Residue
																Natural Gas Used as Fuel in Processing																									Other
																																	Ethane
		Area of Origin 2																															Propane
																																	Normal Butane
																																	Iso Butane
																																	Natural Gasoline
																																	Condensate
PART 3.0 ORIGIN OF NATURAL GAS AND NATURAL GAS LIQUIDS
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Area of Origin Code
Inlet Volume of Natural Gas Received (MMCF)
Liquids Extracted by Product (mBBLs)																												mBBLs								MMCF
Ethane																									243											0																											1.558
Propane																									248											0																											1.499
Normal Butane																									249											0																											1.288
Isobutane																									247											0																											1.245
Natural Gasoline																									220											0																											0.94
Condensate																									210											0																											0.94
Total Natural Gas Liquids																												0								0
Area of Origin Code
Inlet Volume of Natural Gas Received (MMCF)
Liquids Extracted by Product (mBBLs)																												mBBLs								MMCF
Ethane																									243											0																											1.558
Propane																									248											0																											1.499
Normal Butane																									249											0																											1.288
Isobutane																									247											0																											1.245
Natural Gasoline																									220											0																											0.94
Condensate																									210											0																											0.94
Total Natural Gas Liquids																												0								0
Area of Origin Code
Inlet Volume of Natural Gas Received (MMCF)
Liquids Extracted by Product (mBBLs)																												mBBLs								MMCF
Ethane																									243
Propane																									248
Normal Butane																									249
Isobutane																									247
Natural Gasoline																									220
Condensate																									210
Total Natural Gas Liquids																												0								0
Area of Origin Code
Inlet Volume of Natural Gas Received (MMCF)
Liquids Extracted by Product (mBBLs)																												mBBLs								MMCF
Ethane																									243
Propane																									248
Normal Butane																									249
Isobutane																									247
Natural Gasoline																									220
Condensate																									210
Total Natural Gas Liquids																												0								0
Area of Origin Code
Inlet Volume of Natural Gas Received (MMCF)
Liquids Extracted by Product (mBBLs)																												mBBLs								MMCF
Ethane																									243
Propane																									248
Normal Butane																									249
Isobutane																									247
Natural Gasoline																									220
Condensate																									210
Total Natural Gas Liquids																												0								0
PART 4.0 NATURAL GAS USED AS FUEL AND RESIDUE GAS PRODUCTION
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		Total Plant Natural Gas (MMCF)																								Total Electricity Consumption in Processing (kWh)
		Volume of Total Natural Gas Residue								Natural Gas Used on Site as Plant Fuel								Residue Natural Gas Sent to Pipeline
PART 5.0 TOTAL PLANT NATURAL GAS AND LIQUIDS PROCESSING
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	Total Natural Gas Received (MMCF)																												0
	Total Liquids Extracted by Product																												mBBLs								MMCF
	Ethane																									243			0								0																	219.512195121951		342
	Propane																									248			0								0																	202.801867911941		304
	Normal Butane																									249			0								0																	66.3819875776398		86
	Isobutane																									247			0								0																	68.6746987951807		86
	Natural Gasoline																									220			0								0																	101.063829787234		95
	Condensate																									210			0								0																	40.4255319148938		38
	Total Natural Gas Liquids																												0								0
Part 5.1 Summary Table (MMCF)
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	Total Natural Gas Received							Gas Equivalent of NGLs Extracted								Natural Gas Used as Fuel in Processing								Calculated Outlet Residue Natural Gas							Comparison of Calculated to Reported Residue Natural Gas
																															Reported						Calculated - Reported						Percent Difference
	(+)							(-)								(-)								(=)							(4.0)
	0							0								0								0							0						0						0%
5.2 Comments: Identify any changes in plant operations during the report year. A brief comment almost always eliminates time consuming follow up for the respondent.