BSEE-1832 Notification of Incident(s) of Noncompliance

30 CFR 250, Subpart A, General

Form 1832-legal size

30 CFR 250.130-250.192 - Forms

OMB: 1014-0022

Document [doc]
Download: doc | pdf

DEPARTMENT OF THE INTERIOR OMB Control No. 1014-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)

BSEE Rep. (Print Last Name)

BSEE Office Address

Lease No.

Area and Block

Facility/Rig and Well No.

Complex ID 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

INC Description and any Special Orders (shut-in of operations, facility, wells, etc.)

Potential INC/PINC Guidelines at http://www.bsee.gov/regcompliance/inspect.htm

Date Corrected






























































































































BSEE 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 BSEE 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 BSEE 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 BSEE office before returning to operations.

Manager/Supervisor: I certify each Incident of Noncompliance listed above has been corrected on the corresponding date, and I understand that the submission of false statements to the United States is a criminal offense under 18 U.S.C. Section 1001.



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 BSEE, 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 BSEE 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 BSEE collects this information to ensure that facility management is knowledgeable of the incident of noncompliance 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 BSEE 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, Bureau of Safety and Environmental Enforcement, 381 Elden Street, Herndon, VA 20170.


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

File Typeapplication/msword
File TitleOMB Control Number 1010-01114
Authorblundon
Last Modified ByMason, Nicole K
File Modified2012-04-25
File Created2011-08-19

© 2024 OMB.report | Privacy Policy