Form PHMSA F 7000-1.1 PHMSA F 7000-1.1 ANNUAL REPORT FOR CALENDAR YEAR 20___ HAZARDOUS LIQUID O

Notice: This report is required by 49 CFR Part 195. Failure to report may result in a civil penalty not to exceed $100,000 for each violation
for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122.

Form Approved
OMB No. 2137-0614
Expires: **/**/2013

U.S. Department of Transportation
ANNUAL REPORT FOR CALENDAR YEAR 20___
INITIAL REPORT 
Pipeline and Hazardous Materials
HAZARDOUS
LIQUID
OR
CARBON
DIOXIDE
SYSTEMS
SUPPLEMENTAL REPORT 
Safety Administration
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to
comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays
a current valid OMB Control Number. The OMB Control Number for this information collection is 2137-0614. Public reporting for this collection of
information is estimated to be approximately 12 hours per submission, including the time for reviewing instructions, gathering the data needed,
and completing and reviewing the collection of information. All responses to this collection of information are mandatory. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information
Collection Clearance Officer, PHMSA, Office of Pipeline Safety (PHP-30) 1200 New Jersey Avenue, SE, Washington, D.C. 20590.
Important: Please read the separate instructions for completeing this form before you begin.
System Type:

1. Crude Oil



2. HVLs



3. Petroleum & Refined Products

PART A - *OPERATOR INFORMATION
1. NAME OF COMPANY OR ESTABLISHMENT



4. CO2 or other



DOT USE ONLY
3. OPERATOR’S 5 DIGIT IDENTIFICATION NUMBER
/

IF SUBSIDIARY, NAME OF PARENT

/

/

/

/

/

*The operator is the person (as defined in 49 CFR 195.2) who exercises
substantial control over the operation of the pipeline.

___________________________________________________
2. LOCATION OF OFFICE WHERE ADDITIONAL INFORMATION
MAY BE OBTAINED

4.

HEADQUARTERS NAME & ADDRESS, IF DIFFERENT

Number & Street

Number & Street

City & County

City & County

State & Zip Code

State & Zip Code

PART B - MILES OF STEEL PIPE BY LOCATION/PROTECTION
Cathodically protected
Bare

Coated

Cathodically unprotected
Bare

Total Miles That Could Affect HCAs

Coated

Onshore
Offshore

Onshore
Offshore

Total Miles of Pipe

Total Miles

PART C - MILES OF STEEL PIPE BY NOMINAL PIPE SIZE (NPS) BY LOCATION
NPS 4”
6”
8”
10”
12”
or less

Onshore

Offshore

14”

16”

18”

20”

22”

24”

26”

28”

30”

32”

34”

36”

over 36”

NPS 4”
or less

6”

8”

10”

12”

14”

16”

18”

20”

22”

24”

26”

28”

30”

32”

34”

36”

over 36”

Form PHMSA F 7000-1.1 (Rev. 06-2010)

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Reproduction of this form is permitted.

Pre-20
or
Unknow
n

PART D - MILES OF PIPE BY DECADE INSTALLED
1920 1930 1940 1950 –
1960 –
1929
1939
1949
1959
1969

1970 –
1979

1980 –
1989

1990 1999

2000 2009

2010 –
2019

PART E - MILES OF ELECTRONIC RESISTENCE WELD (ERW) PIPE BY WELD TYPE AND DECADE
Pre-40
1940 1950 1960 1970 1980 1990 2000 –
Decade Pipe Installed
or
1949
1959
1969
1979
1989
1999
2009
Unknow
n
High Frequency

2010 –
2019

Total

Total

Low Frequency and DC
Total Miles of Pipe

PART F - MILES OF PIPE BY SPECIFIED MINIMUM YIELD STRENGTH
Onshore Miles

Offshore Miles

Less than or equal to 20 % SMYS
Greater than 20% SMYS
PART G - MILES OF REGULATED GATHERING LINES
PART H BREAKOUT TANKS

Total:

 Check here and proceed to Part I if you submitted breakout tank info via the National Pipeline Mapping System.

Commodity

Total Number of
Tanks Less than or
equal to 50,000 Bbls

Total Number of
Tanks 50,001
to 100,000 Bbls

Total Number of
Tanks 100,001 to
150,000 Bbls

Total Number of
Tanks Over 150,000
Bbls

Total Number
of Tanks

PART I - VOLUME TRANSPORTED IN BARREL-MILES:
System Type 1: Crude oil:
System Type 2: HVLs (flammable or toxic fluids, which are gases at ambient conditions, including anhydrous ammonia):
Of all HVL volumes – report the amount that is anhydrous ammonia only
System Type 3: Refined and/or petroleum products (gasoline, diesel, fuel or other petroleum products, liquid at ambient
conditions):
System Type 4. CO2 or other nonflammable, non-toxic fluids (gases at ambient temperature):
Of all CO2 or other nonflammable, non-toxic fluid volumes - report amount that is CO2 only

Form PHMSA F 7000-1.1 (Rev. 06-2010)

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PART J - INTEGRITY INSPECTIONS CONDUCTED AND ACTIONS TAKEN BASED ON INSPECTION

1. MILEAGE INSPECTED USING THE FOLLOWING IN-LINE INSPECTIONS (ILI) TOOLS
a. Corrosion or metal loss tools
b. Dent or deformation tools
c. Crack or long seam defect detection tools
d. Any other internal inspection tools
e. Total mileage inspected in calendar year using in-line inspection tools (lines a + b + c + d )
2. ACTIONS TAKEN BASED ON IN-LINE INSPECTIONS
a. Based on ILI data, how many anomalies were excavated because they met the operator’s criteria for
excavation.
b. Total number of conditions identified and repaired in calendar year based on the operator’s criteria.
c. Total Number of Anomalies Within an HCA Segment Meeting the Definition of:
1. “immediate repair condition” [195.452(h)(4)(i)]
2. “60 day condition” [195.452(h)(4)(ii)]
3. “180-day condition” [195.452(h)(4)(iii)]
3. PRESSURE TESTING
a. Total mileage inspected by pressure testing.
b. Total number of ruptures (complete failure of pipe wall) during hydrostatic testing.
c. Total number of leaks (less than complete wall failure but including escape of test medium) during hydrostatic
testing.
d. Total number of hydrostatic test failures repaired during calendar year.
4. OTHER INSPECTION TECHNIQUES, INCLUDING DIRECT ASSESSMENT
a. Total mileage inspected by inspection techniques (other than pressure testing and in-line inspection)
b. Total Number of Anomalies Within an HCA Segment Meeting the Definition of:
1. “immediate repair condition” [195.452(h)(4)(i)]
2. “60 day condition” [195.452(h)(4)(ii)]
3. “180-day condition” [195.452(h)(4)(iii)]
c. Total number of conditions identified by other inspection techniques (Lines 4.b.1 + 4.b.2 + 4.b.3) identified and
repaired in calendar year.
5. TOTAL MILEAGE INSPECTED (ALL METHODS) AND ACTIONS TAKEN
a. Total mileage inspected (Lines 1.e + 3.a + 4.a)
b. Total number of conditions repaired (Lines 2.b + 3.d + 4.c)

Form PHMSA F 7000-1.1 (Rev. 06-2010)

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PART K - MILEAGE OF BASELINE ASSESSMENTS COMPLETED
a. Between January 1, 1996 and December 31, 2002 (previously acceptable assessments)
b. Between January 1, 2003 and December 31, 2003
c. Between January 1, 2004 and December 31, 2004
d. Between January 1, 2005 and December 31, 2005
e. Between January 1, 2006 and December 31, 2006
f. Between January 1, 2007 and December 31, 2007
g. Between January 1, 2008 and December 31, 2008
h. Between January 1, 2009 and December 31, 2009
i. Between January 1, 2010 and December 31, 2010
j. Between January 1, 2011 and December 31, 2011
k. Between January 1, 2012 and December 31, 2012
PART L - PREPARER AND AUTHORIZED SIGNATURE

(type or print) Preparer's Name and Title

Area Code and Telephone Number

Area Code and Telephone Number

Authorized Signature

Preparer's E-mail Address

Area Code and Facsimile Number

Senior Executive Officer’s Name and Title Certifying Information
on Part J and K as required by 49 U.S.C. 60109(f):
________________________________________________________________
Senior Executive Officer’s Signature Certifying Information on Part J
and K as required by 49 U.S.C. 60109(f):
Senior Executive Officer’s E-mail Address

Form PHMSA F 7000-1.1 (Rev. 06-2010)
Reproduction of this form is permitted.

Area Code and Telephone Number