Form BSEE-0131 Form BSEE-0131 Performance Measures Data

30 CFR Part 250, Subpart S, Safety and Environmental Management Systems (SEMS)

Form BSEE-0131 exp. 2025 - Program edits 2024 CLEAN

30 CFR 250.1914(e); 1928(d), (e); 1929 - Form BSEE-0131; maintain contractor employee injury/illness log retain for 2 yrs, make available to BSEE; inform re hazards;

OMB: 1014-0017

Document [docx]
Download: docx | pdf

U.S. Department of the Interior

Bureau of Safety and Environmental Enforcement (BSEE)

OMB Control Number 1014-0017 OMB Approval Expires xx/xx/xxxx


PERFORMANCE MEASURES DATA

Provide Data on an Annual Basis for the Previous Calendar Year by March 31 of Each Year


Company Name(s) BSEE Region


Associated Company Name(s) ________________________________


Operator Code(s)* Calendar Year


Contact Name Email Address


Telephone Fax Date



SAFETY

PRODUCTION OPERATIONS

DRILLING** OPERATIONS

CONSTRUCTION OPERATIONS

DECOMMISSION OPERATIONS

A. No. of Company Employee

1st Qtr

Non-DART Recordable Injuries/Illnesses***


2nd Qtr





3rd Qtr


4th Qtr


B. No. of Contract Employee


1st Qtr




Non-DART Recordable Injuries/Illnesses***


2nd Qtr





3rd Qtr


4th Qtr


C. No. of Company Employee


1st Qtr




DART Injuries/Illnesses****


2nd Qtr





3rd Qtr


4th Qtr


D. No. of Contract Employee


1st Qtr




DART Injuries/Illnesses****


2nd Qtr





3rd Qtr


4th Qtr


Form BSEE-0131 (Oct. 2024 - Replaces all previous versions of this form that may not be used.) Page 1 of 2


SAFETY

PRODUCTION

OPERATIONS

DRILLING**

OPERATIONS

CONSTRUCTION

OPERATIONS

CONSTRUCTION

OPERATIONS


E. Company Employee


1st Qtr






Hours Worked


2nd Qtr







Shape1

Qtr

Qtr


3rd 4th


F. Contract Employee

1st Qtr

Hours Worked


2nd Qtr






3rd Qtr


4th Qtr



ENVIRONMENT


  1. For Oil Spills < 1 bbl


    1. No. of Spills


    1. Total Volume for Spills bbl


* Please list all operator codes that these data represent.

** Drilling Operations include Drilling, Workover, and Allied Services.

*** Recordable injuries/illnesses that required medical treatment beyond first aid, but did not result in days away from work, restricted work, or transfer to another job (DART)

**** Formerly Lost Time Cases that include Days Away from work, Restricted duty, and Transfer situations.

Paperwork Reduction Act of 1995 (PRA): The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that BSEE collects this information to carry out its responsibilities under the OCS Lands Act, as amended. BSEE will use the information to evaluate the effectiveness of industry’s continued improvement of safety and environmental management in the OCS. Responses are mandatory (43 U.S.C. 1334). No proprietary data are collected. We estimate the public reporting burden, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the information to average 15 hours per response. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid Office of Management and Budget (OMB) control number. The OMB has approved this collection of information and assigned OMB Control Number 1014-0017. You may direct comments regarding the burden estimate or any other aspect of this collection of information to the Information Collection Clearance Officer, Bureau of Safety and Environmental Enforcement, 45600 Woodland Road, Sterling, VA 20166.


COMPANY-SPECIFIC DATA COLLECTED UNDER THIS REQUEST IS INTENDED FOR GOVERNMENT USE ONLY


Form BSEE-0131 (Oct. 2024 - Replaces all previous versions of this form that may not be used.) Page 2 of 2

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMason, Kye (Nikki)
File Modified0000-00-00
File Created2024-11-01

© 2024 OMB.report | Privacy Policy