Form MMS-1832 Notification of Incident(s) of Noncompliance

U.S. DEPARTMENT OF THE INTERIOR OMB Control Number 1010-0114

Bureau of Ocean Energy Management, Regulation and Enforcement OMB Approval Expires xx/xx/xxxx

NOTIFICATION OF INCIDENT(S) OF NONCOMPLIANCE									Page of
									Date
You are hereby ordered to correct the identified Incident(s) of Noncompliance (INC) listed below. You have the right to appeal any INC Notification in accordance with Title 30 CFR, part 290. You must file your appeal in the office of the official issuing this Notification. However, the filing of an appeal will not suspend the requirement to comply with this Notification.									Time (24-Hour Clock)
									BOEMRE Rep. (Print Last Name)
BOEMRE Office Address			Lease No.		Area and Block		Facility/Rig and Well No.
			Lease Operator (Print)			Drill, Prod, P/L Contractor (Print)		Turnkey Company (Print)
Enforcement Action: W -– Warning C -– Component Shut-in S -– Facility Shut-in
PINC No.	Enf. Action	Authority 30 CFR 250	INC Description and any Special Orders (shut-in of operations, facility, wells, etc.) Potential INC/PINC Guidelines at http://www.BOEMREre.gov/regcompliance/inspect.htm							Date Corrected
BOEMRE Representative Signature				Operator Representative Print Last Name Signature						Date
The operator must insert in the “Date Corrected” column the date each INC was corrected; sign and date the green copy of this form; and return it to the BOEMRE office identified above no later than 14 DAYS from the date of issuance. If the green copy cannot be returned within the allotted time, the operator must obtain a waiver from the appropriate BOEMRE office. This process should ensure that onshore operator management is aware and acknowledges that INCs were issued on this facility, on this date, but in no way delays any enforcement action taken. Unless specifically ordered otherwise, the operator representative must correct and inspect all components and facility shut-in INCs identified and notify the issuing BOEMRE office before returning to operations.
Manager/Supervisor: I certify each Incident of Noncompliance listed above has been corrected on the corresponding date. Print Last Name Signature										Date
Small Business Statement: Your comments are important. The Small Business and Agriculture Regulatory Enforcement Ombudsman and ten Regional Fairness Boards were established to receive comments from small businesses about Federal agency enforcement actions. The Ombudsman will annually evaluate the enforcement activities and rate each agency’s responsiveness to small business. If you wish to comment on the actions of BOEMRE, call 1-888-REG-FAIR (1-888-734-3247). You may comment to the Small Business Administration without fear of retaliation. Disciplinary action for retaliation by a BOEMRE employee may include suspension or termination from employment with the Department of the Interior.
Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that BOEMRE collects this information to ensure that facility management is knowledgeable of the incident of non-compliance issued; corrective action is taken in a reasonable period of time; and for component or facility shut-in enforcement actions, that the identified component or facility is not returned to operation without the prior notice to the appropriate BOEMRE office. Responses are mandatory (43 U.S.C. 1331 et seq.). No proprietary information is collected. An agency may not conduct or sponsor, and you are not required to respond to, a collection of information unless it displays a currently valid OMB Control Number. Public reporting burden for this form is estimated to average 2 hours per response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. You may direct comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Mail Stop 5438, Bureau of Ocean Energy Management, Regulation and Enforcement, 1849 C Street, NW, Washington, DC 20240.

BOEMRE Form MMS-1832 (Mo/Year - Supersedes all previous editions of this form which may not be used.) Page 1 of 1