Form 9100-2 (proposed) 9100-2 (proposed) Offshore Pipeline Condition Report

Notice: Each operator shall, within 60 days after completion of the inspection of all its
underwater pipelines subject to §192.612(a) for natural gas pipelines and §195.413(a) for
hazardous liquid pipelines, report the following information:

Form Approved
OMB No. xxxx-xxxx
Expires: mm/dd/yyyy

OFFSHORE PIPELINE CONDITION REPORT
U.S. Department of Transportation
Report Date: ____________
Pipeline and Hazardous Materials
No. ___________________
Safety Administration
(DOT Use Only)
Please read the separate instructions for completing this form before you begin. They clarify the information requested and
Instructions:
provide specific examples. If you do not have a copy of the instructions, you can obtain one from the Office Of Pipeline
Safety Web Page at http://www.phmsa.dot.gov/pipeline.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is xxxx-xxxx. The filling out of this information is mandatory and will
take XX minutes to complete.

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Part A – Operator Information
1. Pipeline Type: a) Natural Gas … b) Hazardous Liquid …
2. Operator ID: /___/___/___/___/___/

3. Operator Name: ___________________________________

4. Operator Address:
a) __________________________________________ b) __________________________________________
(street)
(city)
d) __________
e) ____________
(state)
(zip code)
Part B – Reporter Information

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1. Date of Report: mm/dd/yyyy

2. Name of Person Submitting Report:_______________________________
a): Job Title: ___________________________________________
b): Phone Number: _______________________
c): Email Address: __________________________________

Part C – Exposed Pipeline Segment Information:

1. Total Length of Pipeline Inspected: ______________ (in miles)
2. Length of Exposed Pipeline Segment: ____________ (in miles)

a): Date of Installation of Exposed Segment: mm/dd/yyyy

b): Location of Exposed Segment: Latitude _______________ Longitude _______________
c): Location per the Minerals Management Service (if known): _________________________

d): State Offshore Area: ___________________ e): Block/Tract #: /___/___/___/___/

Part D – Pipeline Segments Considered Hazards to Navigation (if different from above):
1. Length of Pipeline Segment that is a Hazard to Navigation: ____________ (in miles)
a): Date of Installation of Pipeline Segment: mm/dd/yyyy

b): Location of Pipeline Segment: Latitude _______________ Longitude _______________
c): Location per the Minerals Management Service (if known): _________________________
d): State Offshore Area: ___________________ e): Block/Tract #: /___/___/___/___/

Form PHMSA F####.# (rev. mm/yyyy)

Reproduction of this form is permitted

Page 1 of 1

INSTRUCTIONS FOR FORM PHMSA F XXXX.XX
OFFSHORE PIPELINE CONDITION REPORT

GENERAL INSTRUCTIONS

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Reporting requirements are in Part 191 of Title 49 of the Code of
Federal Regulations (CFR) Transportation of Natural and Other Gas by
Pipeline: Annual Reports, Incident Reports, and Safety-Related
Condition Reports and Part 195 Transportation of Hazardous Liquids by
Pipeline, Subpart B – Annual, Accident, and Safety-Related Condition
Reporting.

As stipulated in §191.27 for natural gas pipelines and §195.57 for
hazardous liquid pipelines, filing offshore pipeline condition reports
are required of each operator within 60 days after completion of the
inspection of all its underwater pipelines subject to §192.612(a) for
natural gas pipelines and §195.413(a) for hazardous liquid pipelines.

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If you need copies of the Form PHMSA F XXXX.XX and/or instructions
they can be found on the Pipeline Safety Community main page,
http://phmsa.dot.gov/pipeline, by clicking the Forms hyperlink and
scrolling down to the section entitled “Accident/Incident/Annual
Reporting Forms.” If you have questions about this report or these
instructions, please call (202) 366-8075. Please type or print all
entries when submitting forms by mail or Fax.
REPORTING METHODS

Use one of the following methods to submit your report. We prefer
online reporting over hardcopy submissions. If you prefer, you can
mail or fax your completed reports to DOT/PHMSA.

Note: Submit a copy of your report directly to the State Regulatory
Agency in addition to submitting to DOT/PHMSA, if that is the
requirement in your state.
1.

Online:
a. Navigate to the Pipeline Safety Community main page
http://phmsa.dot.gov/pipeline, click the ONLINE DATA ENTRY link
listed in the fourth column of hyperlinks
b. Click on the Offshore Pipeline Condition Report link
c. Enter Operator ID and PIN [If an operator does not have an
Operator ID or a PIN, the website
(http://opsweb.rspa.dot.gov/cfdocs/opsapps/pipes/main.cfm)
includes directions on how to obtain one.]

Offshore Pipeline Condition Report_proposed Instructions.doc

d. Click “add” to begin
e. Click “submit” when finished. A confirmation page will appear
for you to print and save for your records
If you submit your report online, PLEASE DO NOT MAIL OR FAX the
completed report to DOT as this may result in duplicate entries.
2.

3.

Mail to:
DOT/PHMSA Office of Pipeline Safety
Information Resources Manager,
1200 New Jersey Ave., SE
East Building, 2nd Floor, (PHP-10)
Room Number E22-321
Washington, DC 20590

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Fax to: Information Resources Manager at (202) 366-4566.

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Offshore Pipeline Condition Report_proposed Instructions.doc

PART A - OPERATOR INFORMATION

Complete the next four items to finish Part A

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1. Pipeline Type – Please select the type of pipeline system this
offshore condition report is being submitted for (i.e., is this a
natural gas pipeline system that you file annual reports for using the
“Natural or Other Gas Transmission & Gathering System” annual report
form; or is this a hazardous liquid pipeline system which you file
annual reports for using the “Hazardous Liquid or Carbon Dioxide
System” annual report form).
2. Operator’s 5 Digit Identification Number _/ _/ _/ _/ _/.

(Note: Depending on when your ID was issued, it may not contain five digits)

3. Operator Name - This is the company name used when registering for
an Operator ID and PIN in the Online Data Entry System.

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The Pipeline and Hazardous Materials Safety Administration (PHMSA)
assigns the operator's five-digit identification number. Contact us at
(202) 366-8075 if you need assistance with an identification number.
A company may submit separate reports for subsidiaries or affiliate
operations under the appropriate operator name and ID number.

4. Operator Address – This should be the operator location office
filing the offshore pipeline condition report. If there is no
location office, please use the headquarters address of the operator
as submitted on the annual reports.

PART B – Reporter Information

For the items in this section, please provide the specific information
related to the person submitting the offshore pipeline condition
report.
1. Date of Report – refers to the actual date the offshore pipeline
condition report is submitted to PHMSA.
2. Name of Person Submitting Report – Please provide the name of the
person submitting the offshore pipeline condition report.
a): Job Title – Please provide the official job title of the
Offshore Pipeline Condition Report_proposed Instructions.doc

person submitting the offshore pipeline condition report.
b): Phone Number – Please provide the phone number of the person
submitting this offshore pipeline condition report.
c): Email Address – Please provide the email address of the
person submitting this offshore pipeline condition report.

PART C – Exposed Pipeline Segment Information

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1.
Total Length of Pipeline Inspected – Please provide the total
length in miles of the pipeline inspected (not just the mileage of the
exposed segment).
If this is an offshore condition report for a
hazardous liquid pipeline, please provide the total length in miles
and NOT kilometers as stated in the regulations.
2. Length of Exposed Pipeline Segment – Please provide the length of
the exposed segment in miles.

a): Date of Installation of Exposed Segment – Provide the date in
mm/dd/yyyy format for when the exposed segment was installed.

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b): Location of Exposed Segment:
Provide the latitude and
longitude of the exposed segment.
Please follow the guidance below
when determining the GPS coordinates.
The latitude and longitude of the offshore pipeline condition
are to be reported as Decimal Degrees with a minimum of 5
decimal places (e.g. Lat: 38.89664 Long: -77.04327). If you
have coordinates in degrees/minutes or degrees/minutes/seconds,
use the formula below to convert to decimal degrees:
degrees + (minutes/60) + (seconds/3600) = decimal degrees
e.g. 38° 53' 47.904" = 38 + (53/60) + (47.904/3600) =
38.89664°

All locations in the United States will have a negative
longitude coordinate. Be sure a negative (-) sign precedes your
longitude coordinate on your report. If you cannot locate the
incident with a GPS or some other means, the U.S. Census Bureau
provides a tool for determining them at the following URL
http://tiger.census.gov/cgi-bin/mapbrowse-tbl. You can use the
online tool to identify the geographic location of the incident.
The tool displays the latitude and longitude in decimal degrees
below the map. Any questions regarding the required format,
conversion or how to use the tool noted above can be directed to
PHMSA’s GIS Manager at (202)493-0591.

c):
Location per the Minerals Management Service: – Only if
known, please provide the location of the exposed pipeline segment as
Offshore Pipeline Condition Report_proposed Instructions.doc

it is referenced by the Minerals Management Service (MMS).
d): State Offshore Area and e) Block/Tract #: Area and
Block/Tract numbers should be provided for either State or OCS waters,
whichever is applicable.
The data collected through this question is intended to allow persons
familiar with the area in which the offshore condition is located to
identify the location and understand it in its local context.
Accordingly, it is not necessary to take measurements to determine
which county/parish is “nearest” in cases where the offshore condition
location is approximately equidistant from two (or more). In such
cases, the name of one of the nearby counties/parishes should be
provided.

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PART D – Pipeline Segments Considered Hazards to Navigation
Note: Only list pipeline segments for Part D that are different from
the segments previously reported in Part C.

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1. Please list the length of pipeline segment (in miles) that is
considered to be a hazard to navigation.
Note: Hazard to navigation means, [for the purposes of 192 and
195] a pipeline where the top of the pipe is less than 12 inches (305
millimeters) below the underwater natural bottom (as determined by
recognized and generally accepted practices) in waters less than 15
feet (4.6 meters) deep, as measured from the mean low water.

a): Date of Installation of Pipeline Segment – Provide the date
in mm/dd/yyyy format for when the pipeline segment was installed.

b):
Location of Pipeline Segment:
Provide the latitude and
longitude of the pipeline segment.
Please follow the guidance given
in Part C, 2, (b) when determining the GPS coordinates.

c):
Location per the Minerals Management Service: – Only if
known, please provide the location of the pipeline segment as it is
referenced by the Minerals Management Service (MMS).
d): State Offshore Area and e) Block/Tract #: Area and
Block/Tract numbers should be provided for either State or OCS waters,
whichever is applicable. Please refer to Part C, 2, (d) & (e)
regarding the data collected for this item.

Offshore Pipeline Condition Report_proposed Instructions.doc