En 509.05 E-5G Utility Accident Report

En 509.05 E-5G Utility Accident Report.#

(a)Each utility shall file department "Form E-5G, Utility Accident Report," dated October 2023 with the department and the commission within 10 working days of when a utility accident, as described in En 508.03(b), occurs, and as required in En 508.03(c).#

(b)Each utility shall include the following on Form E-5G:#

(1)The current, date and name and address of utility;#

(2)Date, time of discovery, and location of accident;#

(3)Description of any person injured including:#

a. Name;#

b. Age;#

c. Residence;#

d. Employer; and#

e. Status of any injured person, whether employee, person under contract, invitee, licensee, trespasser or other;#

(4)Description of injury, current condition, duration of disability and, if applicable, anticipated return to work date;#

(5)Description of cause and manner of accident;#

(6)If applicable, cause of death and previous related accident report number;#

(7)Designation of federal or state statute violated, if applicable;#

(8)Estimated amount of property damage and breakdown of property damage amounts;#

(9)Method of discovery of the accident;#

(10)Estimated amount of gas released measured in terms of 1,000 cubic feet (mcf) and value of gas released, including calculations;#

(11)Time operator or contractor acting on behalf of operator arrived on scene;#

(12)Time operator made pipeline safe;#

(13)Date and time final restoration and return to gas service was completed;#

(14)Quantity of people evacuated and quantity of meters shut off or service interrupted;#

(15)Description of the pipeline facility involved, such as: age, material type, diameter, location, classification, above ground, below ground, depth, pressure at time of accident, map of pipeline;#

(16)Date and time of notification to the National Response Center, if required;#

(17)Recommendation for and steps taken to guard against repetition of accident; and#

(18)The signature, full name and title of the utility employee who supervised the preparation of the report, and date of signature.#

Source. #13796, eff 10-25-23#