Form PHMSA F7 100.3-1 PHMSA F7 100.3-1 Annual Report for Liquefied Natural Gas Facilities

Notice: This report is required by 49 CFR Part 191. 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

ANNUAL REPORT FOR CALENDAR YEAR 20___
LIQUEFIED NATURAL GAS (LNG) FACILITIES

Form Approved
OMB No. 2137-0522
Expires: 10/31/2017
INITIAL REPORT

SUPPLEMENTAL REPORT




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 2137-0522. Public reporting for this collection of
information is estimated to be approximately 12 hours 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.
Important: Please read the separate instructions for completeing this form before you begin. They clarify the information requested and provide
specific examples. If you do not have a copy of the instructions, you can obtain one from the PHMSA Pipeline Safety Community Web Page at
http://www.phmsa.dot.gov/pipeline/library/forms.
PART A - OPERATOR INFORMATION

DOT USE ONLY

1. OPERATOR’S 5 DIGIT IDENTIFICATION NUMBER (OPID)

2. NAME OF COMPANY OR ESTABLISHMENT:

/

/

/

/

/

/
IF SUBSIDIARY, NAME OF PARENT:
__________________________________________________

3. INDIVIDUAL WHERE ADDITIONAL INFORMATION MAY BE
OBTAINED:
Name

4. HEADQUARTERS ADDRESS:

Street Address

State: /

Title

/

/ Zip Code: /

/

__________________________________________________

/__/__/__/-/__/__/__/-/__/__/__/__/

Email Address

Telephone Number

/

/

/

/ - /

/

/__/__/__/-/__/__/__/-/__/__/__/__/
Telephone Number

5. RESERVED

Form PHMSA F 7100.3-1 (rev xy-2013)

Pg. 1 of 4
Reproduction of this form is permitted.

/

/

/

Notice: This report is required by 49 CFR Part 191. 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. 2137-0522
Expires: 10/31/2017

PART B - PLANT DESCRIPTION, TYPE, AND FUNCTION

Name, ID, and Status, should be EXACTLY THE SAME as NPMS fields LNG_NM, LNG_ID, and STATUS_CD.
Location must match the location submitted to NPMS. The LNG Facility ID (LNG_ID in NPMS) is a unique ID for a
specific facility and is assigned by the Operator.
Use the following key to complete the Descriptive table(s) below:
Status Codes
I In Service
B Abandoned
R Retired

LNG Source
T Truck
R Railroad
M Ship/Barge
L Liquefaction

Type of LNG Plant
BL Base Load
PS Peak Shaving
SA Satellite
MT Mobile/Temporary
OT Other  Describe

Function of LNG Plant
MI Marine Terminal - Import
ME Marine Terminal - Export
MB Marine Terminal – Both
SL Storage w/ Liquefaction
SN Storage w/o Liquefaction
SB Storage w/ Both
SU Stranded Utility
VF Vehicular Fuel
NR Nitrogen Rejection Unit
OT Other  Describe
LNG Plant
#1

LNG Plant
#2

Add Plants as
needed

Name of LNG Plant
NPMS LNG ID
Location of Plant
For a fixed LNG Plant, provide the
State (e.g., TX); for a
Mobile/Temporary facility, provide
the Zip Code where it is
typically stored.
Plant Status
Date Put In Service
Process
Maximum Liquefaction Rate
(MMCF/D)
Number of Vaporizers
Maximum Vaporization
Capacity (MMCF/D)
LNG Source
Interstate or Intrastate
LNG Storage
Number of LNG Tanks
Total Capacity (Bbls)
Type of LNG Plant
Function of LNG Plant
Inspection UNIT ID
(DOT INTERNAL USE ONLY)
Form PHMSA F 7100.3-1 (rev xy-2013)

Pg. 2 of 4
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Part 191. 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. 2137-0522
Expires:10/31/2017

For each LNG Plant listed above (that is, for each column completed above), complete PARTs C and D.
PARTs C and D
The data reported in these PARTs C and D apply to LNG PLANT NUMBER /__/__/ (from PART B)

PART C – LEAKS IN PAST YEAR

Record the number of leaks resulting in a release detected and repaired,
by location and cause. (NOTE: Careful review of the instructions is required.)
Leaks
Leaks

Cause

Plant Piping and
Equipment

Storage Tank

Other Location

Totals

External Corrosion

Calc

Internal Corrosion

Calc

Natural Force Damage

Calc

Excavation Damage

Calc

Other Outside Force Damage

Calc

Construction-,
Installation-, or
Fabrication-related

Calc

Original
Manufacturingrelated

Calc

Low Temperature
Embrittlement

Calc

Equipment Failure

Calc

Incorrect Operation

Calc

Other Causes

Calc

In-plant Piping
or Weld ONLY
(For these
types of
failures
involving
Equipment,
see the
Instructions)

Totals

Calc

Calc

Form PHMSA F 7100.3-1 (rev xy-2013)

Calc

Calc

Pg. 3 of 4
Reproduction of this form is permitted.

Notice: This report is required by 49 CFR Part 191. 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. 2137-0522
Expires: 10/31/2017

Record the number of Events.
(NOTE: Careful review of the instructions is required.)

PART D – OTHER EVENTS

TYPE

Number of Events

Rollover
Security Breach
ESD Actuations not reported as
Incidents
- Activated by false signal
- Activated by maintenance or other
non- emergency event
Insulation Degradation
Other Types
Totals

Calc

PART E - PREPARER SIGNATURE
/__/__/__/-/__/__/__/-/__/__/__/__/
Telephone Number

Preparer's Name

/__/__/__/-/__/__/__/-/__/__/__/__/
Preparer's Title

Facsimile Number

Preparer's E-mail Address

Form PHMSA F 7100.3-1 (rev xy-2013)

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

Instructions (rev xy-2013) for PHMSA F 7100.3-1 (rev xy-2013)
ANNUAL REPORT FOR CALENDAR YEAR 20__ LIQUEFIED NATURAL GAS (LNG) FACILITIES

GENERAL INSTRUCTIONS
All section references are to Title 49 of the Code of Federal Regulations (49 CFR). This Annual
Report is required per §191.17 and must be filed per §191.7. Read through the Annual Report and
instructions carefully before beginning to complete the Report. Where common data elements exist
between this Report and an operator’s NPMS submission, the data submitted by the operator on their
Annual Report should be the same as the data submitted through NPMS when possible. (Additionally,
and in order to align an operator’s NPMS submission with their Annual Report data, PHMSA suggests
that operators send their NPMS submission to PHMSA by March 15, representing LNG assets as of
December 31 of the previous year.)
Each operator of a liquefied natural gas facility must submit an Annual Report for that system on DOT
Form PHMSA F 7100.3–1. This report must be submitted each year, not later than March 15, for the
preceding calendar year. In order to improve the accuracy of reported data, operators are requested to
review prior years’ Reports in order to validate that their reported numbers are accurate, or to identify
and correct inconsistencies or errors that are either found or that may exist in any previously reported
data. Operators should file Supplemental Reports as necessary, including those supplementing prior
years’ Reports.
The terms “component,” “liquefied natural gas or LNG,” “LNG Facility,” “LNG Plant,” and
“operator”, are defined in §193.2007.
If you need copies of the Form PHMSA F 7100.3-1 and/or instructions, they can be found on
http://www.phmsa.dot.gov/pipeline/library/forms. The documents are included in the section titled
Accident/Incident/Annual Reporting Forms. If you have questions about this Report or these
instructions,
call
PHMSA’s
Information
Resources
Manager
at
[email protected] or 202-366-8075.

ONLINE REPORTING REQUIREMENTS
Annual Reports must be submitted online through the PHMSA Portal at
https://portal.phmsa.dot.gov/portal, unless an alternate method is approved (see Alternate Reporting
Methods below).
You will not be able to submit reports until you have met all of the Portal registration requirements –
see http://opsweb.phmsa.dot.gov/portal_message/PHMSA_Portal_Registration.pdf
Completing these registration requirements could take several weeks. Plan ahead and register well in
advance of the report due date.

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Instructions (rev xy-2013) for PHMSA F 7100.3-1 (rev xy-2013)
ANNUAL REPORT FOR CALENDAR YEAR 20__ LIQUEFIED NATURAL GAS (LNG) FACILITIES

REPORTING METHOD
Use the following procedure for online reporting:
1. Go to the PHMSA Portal at https://portal.phmsa.dot.gov/portal
2. Enter PHMSA Portal Username and Password ; press enter
3. Select OPID; press “continue” button.
4. Under “Create Reports” on the left side of the screen, under Annual select “LNG ”
and proceed with entering your data. Only one Annual Report for an OPID may be
submitted per year.
5. To save intermediate work without formally submitting it to PHMSA, click Save. To
modify a draft of an Annual Report that you saved, go to Saved Reports and click
on LNG Annual. Locate your saved report by the date or report year. Select the
record by clicking on it once, and then click Modify below the record.
6. Once all sections of the form have been completed, click on Validate to ensure all
required fields have been completed and data meets all other requirements. A list of
errors will be generated that must be fixed prior to submitting an Annual Report.
7. Click Submit when you have completed the Report (for either an Initial Report or a
Supplemental Report), and are ready to initiate formal submission of your Report to
PHMSA.
8. A confirmation message will appear that confirms a record has been successfully
submitted. To save or print a copy of your submission, go to Submitted Reports on
the left hand side, and click on LNG Annual. Locate your submitted report by the
date or report year, and then click on the PDF icon to either open the file and print it,
or save an electronic copy.
9. To submit a Supplemental Report, go to Submitted Reports on the left hand side,
and click on LNG Annual. Locate your submitted report by the date or report year.
Select the record by clicking on it once, and then click “Create Supplemental”.
Alternate Reporting Methods
Operators for whom electronic reporting imposes an undue burden and hardship may submit a written
request for an alternate reporting method. Operators must follow the requirements in §191.7(d) to
request an alternate reporting method and must comply with any conditions imposed as part of
PHMSA’s approval of an alternate reporting method.

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Instructions (rev xy-2013) for PHMSA F 7100.3-1 (rev xy-2013)
ANNUAL REPORT FOR CALENDAR YEAR 20__ LIQUEFIED NATURAL GAS (LNG) FACILITIES

SPECIFIC INSTRUCTIONS
Make an entry in each block for which data is available. Estimate data only if necessary. Avoid
entering any data as UNKNOWN or 0 (zero) except where zero is appropriate to indicate that there
were no instances or amounts of the attribute being reported.
PART A – OPERATOR INFORMATION
Complete all sections of Part A before continuing to Part B.
1. Operator’s 5-digit Identification Number (OPID)
For online entries, the OPID will automatically populate based on the selection you made when
entering the Portal. If you have log-in credentials for multiple OPID, be sure the report is being created
for the appropriate OPID. Contact PHMSA’s Information Resources Manager at 202-366-8075 if you
need assistance with an OPID. Business hours are 8:30 AM to 5:00 PM Eastern Time.

2. Name of Company or Establishment
This is the company name associated with the OPID. When completing the report online, the Name
of Operator is automatically filled in based on the OPID entered in Part A, Question 1. If the name
that appears is not correct, you need to submit an Operator Name Change (Type A) Notification.

If the company corresponding to the OPID is a subsidiary, enter the name of the parent company.
3. Individual where additional information may be obtained
Enter the name, title, email address, and telephone number of the individual who should be
contacted if additional information regarding this Report submission is needed.
4. Headquarters address
For online entries, the headquarters address will automatically populate based on the OPID entered in
A1. If the address that appears is not correct, you need to change it in the online Contacts module.

PART B – PLANT DESCRIPTION, TYPE, AND FUNCTION
Report in Part B all facilities associated with a geographically distinct plant as they existed at the end
of the reporting year. Do not report facilities at the same plant in separate Parts B.
The Name, ID, and Status of the Plant/Facility, should be EXACTLY THE SAME as NPMS fields
LNG_NM, LNG_ID, and STATUS_CD, and the State where the fixed Plant/Facility is located must
match the location submitted to NPMS. It should be noted that the LNG Facility ID (LNG_ID in
NPMS) is a unique ID for a specific facility and is assigned by the Operator.
When reporting the location for Mobile/Temporary facilities, enter the postal zip code where they are
typically stored.
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Instructions (rev xy-2013) for PHMSA F 7100.3-1 (rev xy-2013)
ANNUAL REPORT FOR CALENDAR YEAR 20__ LIQUEFIED NATURAL GAS (LNG) FACILITIES

Interstate or Intrastate
Select Interstate if the LNG Plant/Facility operates under a certificate from the Federal Energy
Regulatory Commission (FERC). Select Intrastate if the LNG Plant/Facility does not operate under a
FERC certificate.
The following descriptions apply to the Type of LNG Plant options:
Base Load: A plant that operates throughout the year to provide gas supply.
Peak Shaving: LNG peak shaving plants are used for storing surplus natural gas for use during peak
demand periods such as winter and summer.
Satellite: Satellite peak shaving plants do not include process equipment to convert natural gas to
LNG. Instead, trucks deliver LNG for storage on site. Satellite peak shaving plants typically inject
natural gas into distribution pipeline systems.
Mobile/Temporary: Mobile LNG plants are those not characterized as permanent infrastructure that
are designed to be easily moved, e.g. skid-mounted or trailer-mounted, or otherwise portable (see
NFPA 59A). Temporary LNG plants are those used for short term applications to provide supply
during planned construction and maintenance activities or in cases of unplanned events such as
peakshaving to meet unanticipated demand.
Other: Describe the Plant type in the space provided.
PART C – LEAKS IN PAST YEAR
Report in Part C unintentional escapes of LNG, liquefied petroleum gas, refrigerant gas, or other gas
from the plant that are not reportable as Incidents under §191.3. A non-hazardous release that can be
eliminated by lubrication, adjustment, or tightening is not a leak. Report leaks originating in plant
piping and equipment, storage tanks, or other locations separately as indicated on the form. Include all
leaks repaired or eliminated, including by replaced pipe or other component during the calendar year.
Do not include test failures.
For the purposes of this Part C, Leaks are to be classified as either:
EXTERNAL CORROSION: includes releases or failures in the pipe or other component due to
galvanic, bacterial, chemical, stray current, or other corrosive action initiating on the outside surface of
the pipe. For PHMSA’s LNG Incident Reporting form, this includes the “External Corrosion” subcause under F1 – Corrosion Failure.
INTERNAL CORROSION: includes releases or failures in the pipe or other component due to
galvanic, bacterial, chemical, stray current, or other corrosive action initiating on the inside surface of
the pipe. From PHMSA’s LNG Incident Reporting form, this includes the “Internal Corrosion” subcause under F1 – Corrosion Failure.

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Instructions (rev xy-2013) for PHMSA F 7100.3-1 (rev xy-2013)
ANNUAL REPORT FOR CALENDAR YEAR 20__ LIQUEFIED NATURAL GAS (LNG) FACILITIES

NATURAL FORCE DAMAGE: includes releases or failures resulting from earth movement,
earthquakes, landslides, subsidence, lightning, heavy rains/floods, washouts, flotation, mudslide,
scouring, temperature, frost heave, frozen components, high winds, or similar natural causes. For
PHMSA’s LNG Incident Reporting form, this includes main cause F2.
EXCAVATION DAMAGE: includes releases or failures resulting directly from excavation damage
by operator's personnel (oftentimes referred to as “first party” excavation damage) or by the operator’s
contractor (oftentimes referred to as “second party” excavation damage) or by people or contractors
not associated with the operator (oftentimes referred to as “third party” excavation damage). Also,
includes releases or failures determined to have resulted from previous damage due to excavation
activity. This category would include damage to aboveground facilities or piping when incurred
during the conduct of excavation activity. For damage from outside forces OTHER than those
associated with excavation activity, Natural Force Damage or Other Outside Force Damage will most
likely apply. For PHMSA’s LNG Incident Reporting form, this includes main cause F3.
OTHER OUTSIDE FORCE DAMAGE: includes, but are not limited to, releases or failures
resulting from non-excavation-related outside forces, such as nearby industrial, man-made, or other
fire or explosion; damage by vehicles or other equipment; releases or failures due to mechanical
damage; and, intentional damage including vandalism and terrorism. For PHMSA’s LNG Incident
Reporting form, this includes main cause F4.
IN-PLANT PIPING OR WELD: Use one of these next three categories to report material failures
only if the item involved in the Incident or leak is in-plant piping or welds. These include releases in
or failures from defects or anomalies within the material of the pipe body or within the pipe seam or
other weld due to faulty manufacturing procedures, defects resulting from poor
construction/installation practices, and in-service stresses such as vibration, fatigue, and low
temperature embrittlement. For PHMSA’s LNG Incident Reporting form, this includes main cause F5.
CONSTRUCTION-, INSTALLATION-, OR FABRICATION-RELATED: includes
releases or failures caused by a dent, gouge, excessive stress, or some other defect or
anomaly introduced during the process of constructing, installing, or fabricating in-plant
piping (or welds which are an integral part of in-plant piping), including welding or other
activities performed at the facility. For PHMSA’s LNG Incident Reporting form, this
includes the sub-cause of the same name under F5.
ORIGINAL MANUFACTURING-RELATED: includes releases or failures caused by
a defect or anomaly introduced during the process of manufacturing the pipe used in inplant piping, including seam defects and defects in the pipe body. For PHMSA’s LNG
Incident Reporting form, this includes the sub-cause of the same name under F5.
LOW TEMPERATURE EMBRITTLEMENT: includes releases in or failures of inplant piping or welds due to the effect of handling cryogenic fluids. Embrittlement
failure of equipment other than in-plant piping or weld, including due to effects of spilled
or leaking cryogenic fluids, should be reported under Equipment Failure. For PHMSA’s
LNG Incident Reporting form, this includes the sub-cause of the same name under F5.

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Instructions (rev xy-2013) for PHMSA F 7100.3-1 (rev xy-2013)
ANNUAL REPORT FOR CALENDAR YEAR 20__ LIQUEFIED NATURAL GAS (LNG) FACILITIES

EQUIPMENT FAILURE: includes releases from or failures of items other than in-plant piping or
welds, and includes releases or failures resulting from: malfunction of control/relief equipment
including valves, regulators, or other instrumentation; failures of pumps or compressors, or pump- or
compressor-related equipment; failures of various types of connectors, connections, and
appurtenances; failures of the body of equipment, vessel plate, or other material (including those
caused by: construction-, installation-, or fabrication-related and original manufacturing-related defects
or anomalies; and low temperature embrittlement); and, all other equipment-related releases or failures.
For PHMSA’s LNG Incident Reporting form, this includes main cause F6.
INCORRECT OPERATION: includes releases or failures resulting from operating, maintenance,
repair, or other errors by facility personnel, including, but not limited to improper valve selection or
operation, inadvertent overpressurization, or improper selection or installation of equipment. For
PHMSA’s LNG Incident Reporting form, this includes main cause F7.
OTHER CAUSES: includes releases or failures resulting from any other cause not listed above,
including those of a miscellaneous or unknown or unknowable nature. For PHMSA’s LNG Incident
Reporting form, this includes main cause F8.
PART D – OTHER EVENTS
Do NOT report events that were reported as Safety-Related Conditions (SRC) under §191.23. If a
SRC report was not filed because corrective action was completed before the filing deadline, include
the event in Part D. Report the number of non-SRC events that were determined to be significant to
safety that occurred at the plants during the reporting year, such as movement of tanks and/or tank
foundations and impairment of the structural integrity or safety of tanks, piping, or other LNG plant
equipment or components. Conditions or events that resulted in a release of LNG, liquefied petroleum
gas, refrigerant gas, or other gas from the plant should be reported in Part C.
Rollover refers to an event in which significant stratification has occurred within a tank and, as a
result, significant quantities of liquefied gas suddenly relocate due to differences in density. Rollovers
have resulted in damage to storage facilities and are safety significant events for LNG carriers and their
unloading operations at import terminals.
Security Breach refers to an actual breach of security. Actuation of security alarms due to
circumstances other than an actual breach need not be reported.
ESD (Emergency Shutdown Device) Actuations that result from actual emergencies must be
reported as Incidents (§§ 191.3 and 191.15). These events need not be reported again here. Report in
this Part ESD Actuations that resulted from causes other than an actual emergency. Report ESD
Actuations that resulted from a false signal separately from those resulting from maintenance or other
non-emergency event at the facility. Do not report intentional, non-emergency ESD’s.
Insulation Degradation refers to reduced effectiveness of insulation (e.g., loss of vacuum) requiring
corrective action. Do not include instances of insulation degradation that contributed to or resulted in a
leak or reportable incident.
Other Types should include major meteorological or geophysical disturbances or other events that the
operator considers to have been significant to safety. Do not report again any events that have been
included in other rows of Part D.
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Instructions (rev xy-2013) for PHMSA F 7100.3-1 (rev xy-2013)
ANNUAL REPORT FOR CALENDAR YEAR 20__ LIQUEFIED NATURAL GAS (LNG) FACILITIES

PART E – PREPARER SIGNATURE
The Preparer is the person who compiled the information and prepared the responses to the Report.
Enter the Preparer’s name and title, and e-mail address if the Preparer has one, and the phone and fax
numbers used by the Preparer.

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