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Run: PHMSA Pipeline Damage Notification

Capture excavation damage details for a gas or hazardous-liquid pipeline in one PHMSA-ready form. It helps operators document the incident, immediate actions...

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Incident Overview

Date of Damage (required)

Select the date the pipeline was damaged or first discovered to be damaged.

Time of Damage or Discovery

Enter the approximate time the damage occurred or was discovered.

Type of Damage (required)

Choose the best match for the observed damage.

Affected Asset Type (required)

Identify the type of pipeline involved.

Discovered By (required)

Select who identified the damage first.

Brief Incident Summary (required)

Provide a concise summary of what happened, including the excavation activity and visible damage.

Location and Asset Details

State (required)

Enter the U.S. state where the damage occurred.

County

Enter the county or parish, if known.

Nearest City or Community

Enter the nearest city, town, or community.

Location Description (required)

Describe the location using milepost, address, cross street, GPS, landmark, or other operational reference.

Pipeline Operator (required)

Enter the operator name for the affected pipeline.

Asset or Line Identifier

Enter the line name, segment ID, station name, or other internal asset identifier if available.

Damage Impact and Immediate Actions

Did anyone sustain an injury? (required)

Select whether the event caused any injury.

Was there a product release? (required)

Select whether gas or hazardous liquid was released.

Did the damage interrupt service? (required)

Select whether pipeline service was interrupted or pressure was reduced.

Immediate Actions Taken (required)

Select all actions taken immediately after the damage was identified.

Injury Details (required)

Describe the injury, including the number of people affected and whether medical attention was provided. Do not include unnecessary PII.

Release Details (required)

Describe the product released, estimated quantity, and whether the release was contained.

Service Interruption Details (required)

Describe the duration, affected customers or area, and any operational restrictions.

Excavation and Contractor Information

Excavator or Contractor Name

Enter the company name of the excavator or contractor, if known.

Excavation Activity Type

Select the type of excavation or ground-disturbing activity involved.

One-Call Ticket Number

Enter the locate ticket number, if available.

Was a locate request made before work began?

Indicate whether the excavator requested utility locates before excavation.

Excavator Contact Method

Select all known methods used to contact the excavator.

Reporting and Review

Reported to Operator At (required)

Enter the date and time the incident was reported to the operator.

Was the reporting timeline met? (required)

Indicate whether the event was reported within the required timeline for internal escalation and PHMSA follow-up.

Requires PHMSA Follow-Up Review

Check this box if the event may require additional regulatory review or reporting.

Yes No N/A

Compliance Review Notes

Add internal review notes, next steps, or references to supporting documents.

Submitter Acknowledgment (required)

I confirm the information provided is accurate to the best of my knowledge and is submitted for compliance and safety follow-up.

Yes No N/A

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