Form BOEM-1832 Notification of Incidents of Noncompliance

U.S. Department of the Interior OMB Control No.: 1010-0114 Bureau of Ocean Energy Management Expiration Date: xx/xx/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 590. 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)
										BOEM Rep. (Print Last Name)
BOEM Office Address			Lease No.			Area and Block		Facility/Rig and Well or Pipeline Segment No.		Complex ID No.
			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.boem.gov/regcompliance/inspect.htm								Date Corrected
BOEM Representative Signature					Operator Representative Print Name Signature						Date
The operator must insert in the “Date Corrected” column the date each INC was corrected; sign and date this form; and return it to the BOEM office identified above no later than 14 DAYS from the date of issuance. If the copy cannot be returned within the allotted time, the operator must obtain a waiver from the appropriate BOEM office. This process should ensure that the Operator’s management is aware of and acknowledges that INCs were issued 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 BOEM office before returning to operations.
Operator’s 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 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 BOEM, 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 BOEM 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 BOEM 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 BOEM 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 Ocean Energy Management, 45600 Woodland Road, Sterling, VA 20166.

Form BOEM-1832 (Month/Year) Page 1 of 1

Previous Editions are Obsolete.