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Pipeline Failure Investigation Report - PHMSA - U.S. Department of ...

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<strong>Pipeline</strong> <strong>Failure</strong> <strong>Investigation</strong> <strong>Report</strong><br />

Odorization<br />

N/A<br />

Temperature: 85 F<br />

Climate (Snow, Rain): Sunny<br />

Weather Conditions<br />

Wind (Direction & Speed): light<br />

Humidity:<br />

N/A<br />

Was Incident preceded by a rapid weather change? Yes No<br />

Weather Conditions Prior to Incident (Cloud Cover, Ceiling Heights, Snow, Rain, Fog):<br />

Clear<br />

Gas Migration Survey<br />

N/A<br />

Bar Hole Test <strong>of</strong> Area: Yes No Equipment Used:<br />

Method <strong>of</strong> Survey (Foundations, Curbs, Manholes, Driveways, Mains, Services)<br />

(9) (1)<br />

Environment Sensitivity Impact<br />

Location (Nearest Rivers, Body <strong>of</strong> Water, Marshlands, Wildlife Refuge, City Water Supplies that could be or were affected<br />

by the medium loss):<br />

N/A<br />

(1)<br />

OPA Contingency Plan Available? Yes No Followed? Yes No<br />

Class Location: 1 2 3 4<br />

Determination:<br />

Odorization Required? Yes No N/A<br />

Class Location/High Consequence Area<br />

Pressure Test History<br />

(Expand List as Necessary)<br />

HCA Area? Yes No N/A<br />

Determination:<br />

N/A<br />

N/A<br />

9 Plot on site description page<br />

- 10 -<br />

Form 11 <strong>Pipeline</strong> <strong>Failure</strong> <strong>Investigation</strong> <strong>Report</strong> (Revised 03/07/08)

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