Form PHMSA F 1000.1 PHMSA F 1000.1 OPID Assignment Form

Notice: This report is required by 49 CFR Parts 191 and 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.

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

Form Approved
OMB No. 2137-0627
Expiration Date: mm/dd/20xy

DOT USE ONLY

OPID ASSIGNMENT REQUEST

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 2137-0627. Public reporting for this
collection of information is estimated to be approximately 60 minutes per response, 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.
STEP 1 – ENTER BASIC REPORT INFORMATION
Date of this OPID Assignment Request:

/

/

/

Month

1.

/

/

/

/

Day

/

/

Year

Are the pipelines and/or facilities covered by this OPID Assignment Request subject to regulation under all or any part of 49
CFR Parts 191, 192, 193, 194, and/or 195?

 Yes
 No  No further action needed.
2.

Are the pipelines and/or facilities covered by this OPID Assignment Request:

 Newly constructed pipelines and/or facilities

 Approximate start date of construction:

/

/

/

/

Month

 Anticipated date of operational start-up:

/

/

/

/

/

Day

/

/

Month

/

/

/

Year

/

/

Day

/

/

Year

 Existing pipelines and/or facilities  2a. Were they previously operated under another OPID?
 No
 Yes  2b. Is the previous OPID Number known?
 No
 Yes  List previous OPID Number: /
/
/
/

/

/

Previous Operator name: ___________________________

3.

Name of Operator: _____________________________________

4.

Operator Headquarters address: _____________________________________
City: _____________________

5.

State: /

/

/

Zip Code: /

/

/

/

/

/

Name of Operator contact for this OPID Assignment Request:
Last ___________________________ First ____________________ MI _

6.

Phone number of Operator contact for this OPID Assignment Request: /
/

7.

Is this Operator a wholly owned subsidiary of another company?
 No
 Yes  Company name: ___________________________

/

Form PHMSA F 1000.1 (rev xy-2014)

/

/-/

/

/

/-/

/

Pg. 1 of 8
Reproduction of this form is permitted.

/

/

Notice: This report is required by 49 CFR Parts 191 and 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.

STEP 2 – ENTER DESCRIPTION OF
PIPELINES AND/OR FACILITIES
1.

Form Approved
OMB No. 2137-0627
Expiration Date: mm/dd/20xy

The questions in this STEP allow PHMSA to accurately portray the scope and nature of
the pipelines and/or facilities covered by this particular OPID Assignment Request and will
also be used by PHMSA for their inspection planning.

The pipelines and/or facilities covered by this OPID Assignment Request are associated with the following types of facilities
and transport the following types of commodities: (select all that apply)
(Complete STEPS 2 and 3 once for each top level facility type in this question that is included in this OPID Assignment
Request.)

 LNG Plant(s) / Facility(ies)
 LNG Storage   Yes  No
 Gas Distribution
 Natural Gas
 Propane Gas
 Landfill Gas
 Synthetic Gas
 Hydrogen Gas
 Other Gas  Name: ___________________________________________
 Gas Transmission
 Gas Transmission
 Natural Gas
 Propane Gas
 Landfill Gas
 Synthetic Gas
 Hydrogen Gas
 Other Gas  Name: ___________________________________________
 Gas Storage Facilities

 Total number:

/___/___/___/___/

 Gas Gathering
 Hazardous Liquid
 Hazardous Liquid Trunkline (regulated non-gathering)
 Crude Oil
 Refined and/or Petroleum Product (non-HVL)
 HVL or Anhydrous Ammonia
 Anhydrous Ammonia
 LPG (Liquefied Petroleum Gas) / NGL (Natural Gas Liquid)
 Other HVL  Name: ___________________________________________
 CO2 (Carbon Dioxide)
 Biofuel / Alternative Fuel (including ethanol blends, but excluding Fuel Grade Ethanol)
 Fuel Grade Ethanol (also referred to as Neat Ethanol)
 Regulated Hazardous Liquid Gathering
 Hazardous Liquid Breakout Tanks
2.

 Total number :

/___/___/___/___/

Will any single pipeline or pipeline facility included in this OPID Assignment Request be subject to BOTH 49 CFR Part 192
AND 49 CFR Part 195 due to the planned transportation of commodities which are subject to both Parts?
 No  Yes

Form PHMSA F 1000.1 (rev xy-2014)

Pg. 2 of 8
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Parts 191 and 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.

3.

Form Approved
OMB No. 2137-0627
Expiration Date: mm/dd/20xy

For the top level pipeline and/or facility type selected in STEP 2, Question 1, complete the following:

For LNG Plant(s) or Facility(ies), the plant(s) and/or facility(ies) covered by this OPID Assignment Request are: (select Interstate
and/or Intrastate, and complete Questions 3a and 3b for each set of Interstate assets and/or Intrastate assets, depending on which
is selected)

 Interstate

 Intrastate
3a. Number of LNG Plants or Facilities covered by this OPID Assignment Request:

/___/___/___/

3b. List all of the States and Counties in which these plant(s)/facility(ies) are physically located:
State 1: /___/___/

Counties: ___________________________________________

State 2: /___/___/

Counties: ___________________________________________

(Add States as needed)
For Gas Distribution, the pipelines and/or facilities covered by this OPID Assignment Request are: (select Type(s) of Operator)
3a. Type of Operator (select all that apply) :

 Municipally Owned State : /___/___/

Miles: /___/___/___/___/___/___/___/

(Add States as needed)

 Privately Owned

State : /___/___/

Miles: /___/___/___/___/___/___/___/

(Add States as needed)

 Investor Owned

State:

/___/___/

Miles:

/___/___/___/___/___/___/

(Add States as needed)

 Select this box if the LPG Distribution pipeline(s) and/or
facility(ies) serve fewer than 100 customers from a single source.

 Cooperative
State: /___/___/
(Add States as needed)

Miles:

/___/___/___/___/___/___/___/

 Master Meter
State : /___/___/
(Add States as needed)

Miles:

/___/___/___/___/___/___/___/

 Other Ownership (State : /___/___/
(Add States as needed)

Miles:

/___/___/___/___/___/___/___/

Describe Ownership: ____________________________________________
3b. Approximate number of regulated miles of Mains:

calc miles

For Gas Gathering, the pipelines covered by this OPID Assignment Request are:

 Onshore
3a. Approximate number of regulated gathering pipeline miles: calc miles
3b. List all of the States in which these pipelines are physically located:
State 1: /___/___/ Miles:
/___/___/___/___/___/___/___/___/___/
Counties: ___________________________________________
State 2: /___/___/ Miles:
/___/___/___/___/___/___/___/___/___/
Counties: ___________________________________________
(Add States as needed)

 Offshore
3c. Approximate number of regulated gathering pipeline miles: calc miles
3d. List all of the OCS areas in which these pipelines and/or facilities are physically located:

Form PHMSA F 1000.1 (rev xy-2014)

Pg. 3 of 8
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Parts 191 and 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.






OCS Atlantic
OCS Gulf of Mexico
OCS Pacific
OCS Alaska

Miles:
Miles:
Miles:
Miles:

Form Approved
OMB No. 2137-0627
Expiration Date: mm/dd/20xy

/___/___/___/___/___/___/___/___/___/
/___/___/___/___/___/___/___/___/___/
/___/___/___/___/___/___/___/___/___/
/___/___/___/___/___/___/___/___/___/

3e. List all of the State waters in which these pipelines and/or facilities are physically located
State 1: /___/___/

Miles:

/___/___/___/___/___/___/___/___/___/

State 2: /___/___/

Miles:

/___/___/___/___/___/___/___/___/___/

(Add States as needed)

For Gas Transmission or Hazardous Liquid, the pipelines and/or facilities covered by this OPID Assignment Request are: (select
Interstate and/or Intrastate, and complete Questions 3a-j for each set of Interstate assets and/or Intrastate assets, and for each
selection of Gas Transmission and/or Hazardous Liquid facilities, depending on which is selected)

 Interstate

 Intrastate

 Onshore
3a. Approximate number of regulated transmission/trunkline pipeline miles: calc miles
3b. List all of the States and Counties in which these pipelines are physically located:
State 1: /___/___/
Miles:
/___/___/___/___/___/___/___/___/___/
Counties: ___________________________________________
State 2: /___/___/
Miles:
/___/___/___/___/___/___/___/___/___/
Counties: ___________________________________________
(Add States as needed)
3c. Approximate number of regulated Hazardous Liquid gathering miles: calc

miles

3d. List all of the States and Counties in which these Hazardous Liquid gathering lines are physically
located:
State 1: /___/___/

Counties: ________________________________________

State 2: /___/___/

Counties: ________________________________________

(Add States as needed)
3e. List all of the States and Counties in which other facilities (including storage/breakout tanks) are
physically located
State 1: /___/___/

Counties: ________________________________________

State 2: /___/___/

Counties: ________________________________________

(Add States as needed)

 Offshore
3g. Approximate number of regulated transmission/trunkline pipeline miles: calc miles
3h. Reserved
3i. If Interstate, list all of the OCS Areas in which these Interstate pipelines and/or facilities are
physically located:






OCS Atlantic
OCS Gulf of Mexico
OCS Pacific
OCS Alaska

Miles:
Miles:
Miles:
Miles:

Form PHMSA F 1000.1 (rev xy-2014)

/___/___/___/___/___/___/___/___/___/
/___/___/___/___/___/___/___/___/___/
/___/___/___/___/___/___/___/___/___/
/___/___/___/___/___/___/___/___/___/

Pg. 4 of 8
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Parts 191 and 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. 2137-0627
Expiration Date: mm/dd/20xy

3j. If Interstate or Intrastate, list all of the State waters in which these pipelines and/or facilities are
physically located:
State 1: /___/___/

Miles:

/___/___/___/___/___/___/___/___/___/

State 2: /___/___/

Miles:

/___/___/___/___/___/___/___/___/___/

(Add States as needed)

4.

Provide a brief and general description of the pipelines and/or facilities covered by this OPID Assignment Request. Describe each second
level selection from STEP 2, Question 1 separately.

In addition to the information provided below, Operators are encouraged to provide a general overview map (or maps) depicting the
approximate geographic location of the pipelines and/or facilities covered by this OPID Assignment Request.

__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________

STEP 3 – PROVIDE PHMSA-REQUIRED PIPELINE
SAFETY PROGRAM OR LNG SAFETY PROGRAM
INFORMATION

This STEP serves to notify PHMSA of relationships among OPIDs so that
compliance performance can be accurately portrayed, as well as to facilitate
PHMSA’s resource planning and preparation in the conduct of inspections of these
PHMSA-required safety programs.

Important Instruction to Operator: When a common PHMSA-required pipeline safety program(s) or LNG safety program(s) exists
which covers assets having multiple OPID numbers, the Operators assigned those OPIDs are required to inform PHMSA as to
which one of the various OPIDs is “primary” for the purposes of PHMSA inspections and Operator Registry Reporting (e.g., which
OPID should be contacted and referred to when PHMSA or a state exercising jurisdiction intends to inspect that safety program),
and must do so for each PHMSA-required pipeline safety program or LNG safety program listed below.
1.

Are the pipelines and/or facilities covered by this OPID Assignment Request included with other OPIDs for the purposes of
compliance with one or more PHMSA-required pipeline safety program(s) or LNG safety program(s)? (select only one)

 Not known at this time. (Note: The Operator must submit an Operator Registry Notification informing PHMSA of the
primary responsibility for managing or administering these PHMSA-required safety programs within 60 days after they are
known. Operators should note that many of these programs are required to be in place before initial operations of the
pipelines and/or facilities commence.)

Form PHMSA F 1000.1 (rev xy-2014)

Pg. 5 of 8
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Parts 191 and 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. 2137-0627
Expiration Date: mm/dd/20xy

 No, the pipelines and/or facilities covered by this OPID Assignment Request have their own independent PHMSArequired safety programs which include no other OPIDs for the following, when applicable:
[For ALL facilities] Anti-Drug Plan and Alcohol Misuse Plan (199.101, 199.202); Procedure Manual
for Operations, Maintenance, and Emergencies (192.605, 192.615, 195.402, 193.2017);
[For Gas Distribution, Gas Gathering, Gas Transmission, and Hazardous Liquid Pipeline
Facilities] Damage Prevention Program (192.614, 195.442); Public Awareness/Education Program
(192.616, 195.440); Control Room Management Procedures (192.631, 195.446); Operator
Qualification Program (192.805, 195.505); and, Integrity Management Program (192.907, 192.1005,
195.452).
[For Hazardous Liquid Pipeline Facilities ONLY] Response Plan for Onshore Oil Pipelines (or
Alternative State Plan) (194.101).

 Yes, the pipelines and/or facilities covered by this OPID Assignment Request have one or more PHMSA-required
pipeline safety program(s) or LNG safety program(s) that also apply to pipeline assets with other OPID numbers for the
purposes of compliance with PHMSA regulations.
If Yes, list the Operator-designated “primary” OPID for each common PHMSA-required pipeline safety
program associated with this OPID Assignment Request. Those programs not selected will be
considered to be either not required or independent programs which cover only the pipelines and/or
facilities covered by this OPID Assignment Request: (select all that apply)
1a.

 Anti-Drug Plan and Alcohol Misuse Plan (199.101, 199.202)
/

/

/

/

/

/

1b.  Procedure Manual for Operations, Maintenance, and Emergencies (192.605, 192.615, 195.402,
193.2017)
/
1c.

/

/

/

/

/

/

/

/

/

/

/

/

 Control Room Management Procedures (192.631, 195.446)
/

1f.

/

 Public Awareness/Education Program (192.616, 195.440)
/

1e.

/

 Damage Prevention Program (192.614, 195.442)
/

1d.

/

/

/

/

/

/

 Operator Qualification Program (192.805, 195.505)
/

/

/

/

/

/

Form PHMSA F 1000.1 (rev xy-2014)

Pg. 6 of 8
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Parts 191 and 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.

 Integrity Management Program (192.907, 192.1005, 195.452)

1g.

/
1h.

/

/

/

/

/

/

/

/

/

This STEP ensures that PHMSA has the contact information it needs for the basic
forms of Agency-Operator interaction that may occur.

STEP 4 – PROVIDE CONTACT INFORMATION

Operator contact overseeing compliance with 49 CFR Parts 191-199, i.e. the primary contact for regulatory issues:
Name: Last ___________________________ First ____________________ MI _
Title: _________________________________
Address:
Street_______________________________________ or P.O. Box______________
City: _____________________
State: / / /
Zip Code: /
/
/
/
/
/
Office Phone: /
Cell Phone: /

2.

/

 Response Plan for Onshore Oil Pipelines (or Alternative State Plan) (194.101)
/

1.

Form Approved
OMB No. 2137-0627
Expiration Date: mm/dd/20xy

/
/

/
/

/-/
/-/

/
/

/
/

/-/
/-/

/
/

/
/

/

/

/

E-mail: __________________________

/

Operator contact for information pertaining to PHMSA’s inspection scheduling, if different from above: (Provide one
contact for each PHMSA Regional Office where pipelines and/or facilities covered by this OPID Assignment Request are
physically located)
2a. PHMSA Region: __________________
Name: Last ___________________________ First ____________________ MI _
Title: _______________________ _________
Address:
Street_______________________________________ or P.O. Box______________
City: _____________________
State: / / /
Zip Code: /
/
/
/
/
_

Office Phone: /
Cell Phone: /

/
/

/
/

/-/
/-/

/
/

/
/

/-/
/-/

/
/

/
/

/

/

/

/

E-mail: __________________________

/

(Add additional Operator contacts for other PHMSA Regional Offices where pipelines and/or facilities covered by this OPID
Assignment Request are physically located, continuing with 2b, 2c, etc. as needed.)
3.

24/7 Operator contact for emergency situations (natural disasters, national emergencies, security threats, extreme weather
events, etc.):
Name: Last ___________________________ First ____________________ MI _
Title: _________________________________
Address:
Street_______________________________________ or P.O. Box______________
City: _____________________
State: / / /
Zip Code: /
/
/
/
/
/
Office Phone: /
Cell Phone: /

/
/

/
/

/-/
/-/

/
/

/
/

/-/
/-/

/
/

/
/

/

/

/

E-mail: __________________________

/

4.

24/7 Operator phone number for normal operations:

Phone: /

/

/

/-/

/

/

/-/

/

/

/

/

5.

24/7 Operator Control Center phone number:

Phone: /

/

/

/-/

/

/

/-/

/

/

/

/

6.

Operator’s Senior Executive Official:
Name: Last ___________________________ First ____________________ MI _
Title: _________________________________
Address:
Street_______________________________________ or P.O. Box______________
City: _____________________
State: / / /
Zip Code: /
/
/
/
/
Office Phone: /
Cell Phone: /

/
/

/
/

/-/
/-/

/
/

/
/

/-/
/-/

/
/

/
/

/
/

/

/

E-mail: __________________________

/

Form PHMSA F 1000.1 (rev xy-2014)

Pg. 7 of 8
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Parts 191 and 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.

7.

Operator contact for information pertaining to NPMS submissions:
Name: Last ___________________________ First ____________________ MI _
Title: _________________________________
Address:
Street_______________________________________ or P.O. Box______________
City: _____________________
State: / / /
Zip Code: /
/
/
/
/
Office Phone: /
Cell Phone: /

8.

/
/

/-/
/-/

/
/

/
/

/-/
/-/

/
/

/
/

/
/

/

/

E-mail: __________________________

/

Operator contact responsible for assuring compliance with DOT’s Anti-Drug and Alcohol Misuse regulations (49 CFR
199):
Name: Last ___________________________ First ____________________ MI _
Title: _________________________________
Address:
Street_______________________________________ or P.O. Box______________
City: _____________________
State: / / /
Zip Code: /
/
/
/
/
/
Office Phone: /
Cell Phone: /

9.

/
/

Form Approved
OMB No. 2137-0627
Expiration Date: mm/dd/20xy

/
/

/
/

/-/
/-/

/
/

/
/

/-/
/-/

/
/

/
/

/
/

/

E-mail: __________________________

/

User Fee contact:
Name: Last ___________________________ First ____________________ MI _
Title: _________________________________
Address:
Street_______________________________________ or P.O. Box______________
City: _____________________
State: / / /
Zip Code: /
/
/
/
/
Office Phone: /
Cell Phone: /

/
/

/
/

/-/
/-/

/
/

/
/

/-/
/-/

/
/

/
/

/
/

/

/

E-mail: __________________________

/

Form PHMSA F 1000.1 (rev xy-2014)

Pg. 8 of 8
Reproduction of this form is permitted.