PHMSA F 999-95 Hazardous Liquid Base Grant Progress Report

1200 New Jersey Avenue SE
Washington DC 20590

U.S. Department
of Transportation
Pipeline and Hazardous
Materials Safety
Administration

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information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Pipeline and Hazardous
Materials Safety Administration (PHMSA), PHP-30, 1200 New Jersey Ave SE, Washington, D.C. 20590

Pipeline Safety
20xx Hazardous Liquid Base Grant Progress Report
for

Please follow the directions listed below:
1. Review the entire document for completeness.
2. Review and have an authorized signatory sign and date page 2.
3. Scan the signed document to your computer and email it to Carrie.Winslow@dot.gov.

FedSTAR Information
Electronic Submission Date:

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Pipeline and Hazardous Materials Safety Administration
1200 New Jersey Avenue, SE
Washington DC 20590

OFFICE OF PIPELINE SAFETY
20xx Hazardous Liquid Base Grant Progress Report

Office:

DRAFT
Authorized Signature

Printed Name

Title

Date

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PROGRESS REPORT ATTACHMENTS (HAZARDOUS LIQUID )
PHMSA Form No. PHMSA F 999-95
Attachment 1: State Jurisdiction and Agent Status over Facilities.
Attachment 2: State Field Inspection Activity
Attachment 3: Facilities Subject to State Safety Jurisdiction
Attachment 4: Pipeline Incidents
Attachment 5:State Compliance Actions
Attachment 6: State Record Maintenance and Reporting
Attachment 7: State Employees Directly Involved in the Pipeline Safety Program
Attachment 8: State Compliance with Federal Regulations
{there is no attachment 9}
Attachment 10: Performance and Damage Prevention Questions

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Attachment 1 - Stats on Operators
STATE JURISDICTION AND AGENT STATUS OVER HAZARDOUS LIQUID FACILITIES
AS OF DECEMBER 31, 20xx

Operator Type

State Agency Jurisdiction/
Agent Status
No1

No. of
Operators

Yes

Operators
Inspected
#

%

No. of
Inspection
Units

Units Inspected
#

%

Hazardous Liquid
Intrastate Refined Petroleum
Products
Intrastate Crude Oil
Intrastate HVL Flamm Toxic
Intrastate CO2
Intrastate Biofuel
Products
Interstate Crude Oil
Interstate HVL Flamm Toxic
Interstate CO2
Interstate Biofuel

Total

Codes: A - None in state and does not have jurisdiction;
B - State does not have jurisdictional authority (Provide current status or action being taken to obtain authority
in notes section below)

F - No, State is currently not an interstate agent.

X/60105P = Yes, I have Section 60105 (Certification) over some of the operator type (meaning: I have 60105
authority over some, but not all of this operator type and do not have a 60106 agreement with PHMSA to inspect
them). These operators are identified in the notes below.
X/IA - Yes, I have Interstate Agent jurisdiction over this type of operator
Distribution "Other" - ie Co-ops, Public Utility Districts, etc.
States should explain any special circumstances
General Instructions - All above facilities should only include facilities as defined by federal pipeline regulations
and should not include extended jurisdiction by state regulation.
Attachment 1 Notes:

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Attachment 2 - State Inspection Activity
TOTAL STATE FIELD INSPECTION ACTIVITY
AS OF DECEMBER 31, 20xx

Operator Type

Design,
Standard
Testing and
Comprehensive
Construction

On-Site
Operator
Training

Investigating
Damage
Incidents or
Integrity
Operator
Compliance
Prevention
Management Qualification Accidents
Follow-up
Activities

Total

Hazardous Liquid
Intrastate Refined Petroleum Products
Intrastate Crude Oil
Intrastate HVL Flamm Toxic
Intrastate CO2
Intrastate Biofuel
Interstate Refined Petroleum Products
Interstate Crude Oil
Interstate HVL Flamm Toxic
Interstate CO2
Interstate Biofuel

Total

Drug and Alcohol
Total Count of Drug and Alcohol Inspections
Attachment 2 Notes

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Attachment 3 - List of Operators
HAZARDOUS LIQUID FACILITIES SUBJECT TO STATE SAFETY JURISDICTION AS OF DECEMBER 31, 20xx

Operator
Business Name
Operator ID
Address

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Intrastate
Refined
Petroleum
Products

Hazardous Liquid
(Operator type & Inspection Units)
Intrastate Intrastate Intrastate Intrastate Interstate Interstate Interstate Interstate Interstate
Crude Oil
HVL
CO2
Biofuel
Refined Crude oil
HVL
CO2
Biofuel
Flamm
Petroleum
Flamm
Toxic
Products
Toxic

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Intrastate
Refined
Petroleum
Products

Hazardous Liquid
(Operator type & Inspection Units)
Intrastate Intrastate Intrastate Intrastate Interstate Interstate Interstate Interstate Interstate
Crude Oil
HVL
CO2
Biofuel
Refined Crude oil
HVL
CO2
Biofuel
Flamm
Petroleum
Flamm
Toxic
Products
Toxic

Inspection Unit totals by type

Total Operators
Attachment 3 Notes

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Attachment 4 - Incidents/Accidents
SIGNIFICANT4 HAZARDOUS LIQUID INCIDENTS/ACCIDENTS JANUARY 1, THROUGH DECEMBER 31, 20xx
Date of
Incident

Location City/County/etc.

System Injuries FatalitiesProperty
#
#
Damage3
Type
$

Operator State
Cause
Cause
1
Code1
Code

Name of Operator:
Operator ID:

Report No:

Summary

2

High Level Cause Codes: A - Corrosion failure; B - Natural Force Damage; C - Excavation Damage; D - Other
Outside Force Damage; E - Pipe, Weld or Joint Failure; F - Equipment Failure; G - Incorrect Operation; H - Other
Incident Cause; IP - Investigation Pending;
Please include a summary or report of the state agency's investigation of each of the above incidents.
Interstate agents should use the 191.3 Incident definition for listing incidents investigated on interstate facilities.
Attachment 4 Notes

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Attachment 5 - Stats on Compliance Actions
STATE COMPLIANCE ACTIONS -- CALENDAR YEAR (CY) 20xx
Probable Violation Categories

Intrastate

Interstate

Number carried over from all previous CY's
Number Found During CY
Number submitted for DOT action [60106 Agreement agent
only]
Number corrected during CY (including carry over from
previous year(s))
Number to be corrected at end of CY (including carry over)
Number of Compliance Actions Taken
(see definition)
Civil Penalties
Number assessed during CY
Dollars assessed during CY
Number collected during CY
Dollars collected during CY
Do not double count for a related series of actions.

1

Attachment 5 Notes

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Attachment 6 - List of Records Kept
HAZARDOUS LIQUID STATE RECORD MAINTENANCE AND
REPORTING DURING CY 20xx
Records Maintained by the State Agency

Reports Required from Operators

Attachment 6 Notes

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Attachment 7 - Staffing
STATE EMPLOYEES DIRECTLY INVOLVED IN THE HAZARDOUS LIQUID
PIPELINE SAFETY PROGRAM DURING CY 20xx
Name/Title

%
Time

#
Qual.
Months Cat.

Summary
No. of Staff
Employee Type
Supervisor
Damage Prevention/Technical
Inspectors/Investigators
Clerical/Administrative
Total

Person-Years

Attachment 7 Notes

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Attachment 8 - Compliance with Federal Regulations
STATE COMPLIANCE WITH FEDERAL REQUIREMENTS AS OF DECEMBER 31, 20xx

No.

Effective
Date

1

Maximum Penalties Substantially same as DOT ($222,504/$2,225,034). State
must adopt minimum penalties of at least ($100,000/$1,000,000). Indicate actual 08/2008
amount in notes.

Impact

Adoption
AdoptionStatus
Date
Adopted ($100,000/$1,000,000)

Note1

2

Part 195 Amendments

1-95

Pre 2011

Note1

Adoption of all amendments prior to 2011

[All applicable amendments prior to and including 2010]

96 - 76 FR 25576
Note1
97 - 76 FR 35130

8/15/2011

Note

.

98 - 78 FR 58897

10/25/2013

Administrative Procedures, Updates, and Technical Corrections (Not
applicable to States)

3/6/2015

Periodic Updates of Regulatory References to Technical Standards and
Miscellaneous Edits

1

Control Room Management/Human Factors

Note1
99 - 80 FR 168
Note1
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100 - 80 FR 12779 10/1/2015
Note

.

101 - 82 FR 7972

3/24/2017

1

Miscellaneous Changes to Pipeline Safety Regulations
Operator Qualification, Cost Recovery, Accident and Incident
Notification, and Other Pipeline Safety Changes

Note1
102 - 84 FR 52260 7/1/2020

Pipeline Safety: Safety of Hazardous Liquid Pipelines

Note

1

3

Part 199 - Drug Testing

Note

1

4

Part 199 Amendments

1-24

Pre 2011

Note1

Adoption of all amendments prior to 2011

25 - 78 FR 58897

10/25/2013

Administrative Procedures, Updates, and Technical Corrections

3/6/2015

Periodic Updates of Regulatory References to Technical Standards and
Miscellaneous Edits

3/24/2017

Operator Qualification, Cost Recovery, Accident and Incident
Notification, and Other Pipeline Safety Changes

4/23/2019

Conforming Amendments and Technical Corrections to Department
Rules Implementing the Transportation Industry Drug Testing
Program

[All applicable amendments prior to and including 2010]

Note1
26 - 80 FR 168
Note1
27 - 82 FR 7972
Note1
28 - 84 FR 16770
Note1
5

State Adoption of Part 198 State One-Call Damage Prevention Program

a.

Mandatory coverage of areas having pipeline facilities

Note

1

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b.

Qualification for operation of one-call system

Note

1

c.

Mandatory excavator notification of one call center

Note1
d.

State determination whether calls to center are toll free

Note1
e.

Mandatory intrastate pipeline operator participation

Note1
f.

Mandatory operator response to notification

Note1
g.

Mandatory notifications of excavators/public

Note

1

h.

Civil penalties/injunctive relief substantially same as DOT

Note

1

If Adoption Status is No, Please provide an explanation
State Attendance at 2020 NAPSR Regional Meeting:
Frequency of General Legislative Session: Annually

1

Attachment 8 Notes

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Attachment 10 - Performance and Damage Prevention Questions
CALENDAR YEAR (CY) 20xx
Planned Performance: What are your Planned Annual and Long-term goals for your Pipeline Safety Program?

Past Performance: What did the Pipeline Safety Program accomplish during the subject year (to this document) to contribute
toward the program's annual and long-term goals?

1. Has the state or agency reviewed the Damage Prevention Assistance Program (DPAP) document in the last twelve months?

2. Has the state or agency developed or is in the process of developing a plan to address the nine elements contained in the PIPES
Act of 2006 for an effective State Damage Prevention Program?

If yes to question 2, where does the state or agency stand on implementation of the nine elements contained in the PIPES Act of
2006? Please provide a description of how the state or agency has or will meet each element. If not, please provide a brief passage
explaining the reasons why the state or agency has not.

Attachment 10 Notes

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