I
(See rule 13)Particulars to be included in design intimation for fixed offshore installation.1. The name and address of the operator :
2. Name and address of the licensee or lessee :
3. Confirmation that all the relevant provisions mentioned in the rules have been considered in the design :
4. A description of :
(a)the design concept, including suitable diagrams.(b)how the chosen design concept will ensure that risks with the potential to cause a major accident are reduced to the lowest level that is reasonably practicable.5. A general description of :
(a)the principal systems on the installation including systems for monitoring and control of hazardous situations.(b)the installation layout.(c)the principal features (including major accident prevention) of pipelines, if any, to be connected to the installation.(d)any hydrocarbon bearing reservoir intended to be exploited using the installation.6. Particulars of the types of operation, and activities in connection with each operation, which the installation is planning to perform.
7. A general description of the means by which the management system of the operator will ensure that the structure and plant of the installation will be designed, selected, constructed, commissioned, operated and decommissioned in a way which will reduce any risk of a major accident to the lowest level that is reasonably practicable.
II
(See rule 14)Particulars to be included in application for consent for operation of new fixed offshore installation.1. The name and address of the operator :
2. Name and address of the licensee or lessee :
3. A description of the extent to which the operator has taken into account any matters raised by the competent authority on design intimation for fixed offshore installation :
4. Confirmation that all the relevant provisions mentioned in the rules have been complied with :
5. Confirmation that environmental clearances and other statutory clearances have been obtained/applied for, to the relevant authorities :
6. Copy of the safety management system document :
7. A general description, with suitable diagrams, of :
(a)the structure of the installation and its materials.(b)the plant including the layout and configuration and systems for monitoring and control of hazardous situations.(c)the connections to any pipeline or installation.(d)any wells to be connected to the installation.8. Particulars of the types of operation, and activities in connection with each operation, which the installation is to be capable of performing.
9. The maximum number of persons -
(a)expected to be on the installation at any time, and(b)for whom accommodation is to be provided.10. A description of (as applicable) :
(a)plant and arrangement for control of well operations (including pressure control and prevention of uncontrolled release).(b)major accident prevention measures for pipelines, to be connected to the installation.11. Description of the life saving appliances and fire fighting arrangement.
12. Detail description of emergency response plans (covering all identified major hazards), pursuant to the rules under Chapter X on emergency response system.
13. Particulars of any combined operations which may involve the installation, including summary of the arrangements in place for co-ordinating the safety management systems and joint review of the safety aspects by the operator and other participants, involved in combined operations.
III
(See rule 15)Particulars to be included in application for consent for existing fixed offshore installation.1. The name and address of the operator :
2. Name and address of the licensee or lessee :
3. The list of the relevant rules, which are not complied with :
4. Time bound action plan to comply with the rules, as per item 3 :
5. The rules, as per item 3, which the operator considers infeasible to be complied with, along with detail justification/reasoning, including suggested alternatives/control measures :
6. Confirmation that environmental clearances and other statutory clearances have been obtained from the relevant authorities :
7. Copy of the safety management system document :
8. A general description, with suitable diagrams, of :
(a)its plant including the layout and configuration and systems for monitoring and control of hazardous situations.(b)the connections to any pipeline or installation.(c)any wells connected to the installation.9. Particulars of the types of operation, and activities in connection with each operation, which the installation is capable of performing.
10. The maximum number of persons -
(a)on the installation at any time, and(b)for whom accommodation is provided11. A description of (as applicable) :
(a)plant and arrangement for control of well operations (including pressure control and prevention of uncontrolled release).(b)major accident prevention measures for pipelines, connected to the installation.12. Description of the life saving appliances and fire fighting arrangement :
13. Detail description of emergency response plans (covering all identified major hazards), pursuant to the rules under Chapter X on emergency response system :
14. Particulars of any combined operations which may involve the installation, including summary of the arrangements in place for co-ordinating the safety management systems and joint review of the safety aspects by the operator and other participants, involved in combined operations :
IV
(See rule 16)Particulars to be included in application for consent for mobile offshore installation.1. The name and address of the operator :
2. Name and address of the licensee or lessee :
3. Confirmation that all the relevant provisions mentioned in the rules have been complied with :
4. Copy of the safety management system document :
5. A general description, with suitable diagrams, of :
(a)the structure of the installation and its materials.(b)its plant including the layout and configuration and systems for monitoring and control of hazardous situations.(c)the connections to any pipeline or installation.(d)any wells to be connected to the installation.6. Particulars of the types of operation, and activities in connection with each operation, which the installation is to be capable of performing.
7. The maximum number of persons -
(a)expected to be on the installation at any time, and(b)for whom accommodation is to be provided8. A description of (as applicable) :
(a)plant and arrangement for control of well operations (including pressure control and prevention of uncontrolled release).(b)major accident prevention measures for pipelines, to be connected to the installation.9. Description of the life saving appliances and fire fighting arrangement.
10. Detail description of emergency response plans (covering all identified major hazards), pursuant to the rules under Chapter X on emergency response system.
11. Particulars of any combined operations which may involve the installation, including summary of the arrangements in place for co-ordinating the safety management systems and joint review of the safety aspects by the operator and other participants, involved in combined operations.
V
(See rule 17)Particulars to be included in application for consent for already operating mobile offshore installation.1. The name and address of the operator :
2. Name and address of the licensee or lessee :
3. The list of the relevant rules, which are not complied with :
4. Time bound action plan to comply with the rules, as per item 3 :
5. The rules, as per item 3, which the operator considers infeasible to be complied with, along with detail justification/reasoning, including suggested alternatives/ control measures.
6. Copy of the safety management system document.
7. A general description, with suitable diagrams, of :
(a)its plant including the layout and configuration and systems for monitoring and control of hazardous situations.(b)the connections to any pipeline or installation.(c)any wells connected to the installation.8. Particulars of the types of operation, and activities in connection with each operation, which the installation is capable of performing.
9. The maximum number of persons -
(a)on the installation at any time, and(b)for whom accommodation is provided10. A description of (as applicable) :
(a)plant and arrangement for control of well operations (including pressure control and prevention of uncontrolled release).(b)major accident prevention measures for pipelines, connected to the installation.11. Description of the life saving appliances and fire fighting arrangement.
12. Detail description of emergency response plans (covering all identified major hazards), pursuant to the rules under Chapter X on emergency response system.
13. Particulars of any combined operations which may involve the installation, including summary of the arrangements in place for co-ordinating the safety management systems and joint review of the safety aspects by the operator and other participants, involved in combined operations.
VI
(See rule 19)Particulars to be included in a relocation intimation for production offshore installation1. The name and address of the operator :
2. Name and address of the licensee or lessee :
3. Changes, if any, in the types of operation, and activities in connection with an operation, at the existing and the new location of the installation.
4. Explanation of why the operator considers the installation suitable for the new location.
FORM 1INTIMATION CONCERNING OFFSHORE INSTALLATION(See rule 9 )1. Name and address of the operator :
2. Name and location of offshore installation : (longitude/latitude)
3. Name of licensed or leased area in which : installation is being or to be used
4. Type of installation (fixed or mobile) :
5. Type of operations (drilling or production or work-over or others) :
6. Date of commencement of operations
(i)Existing installations(a)Mobile Date of entry in relevant waters :(b)Fixed Date of commencement of operations :(a)Mobile Date of intended entry in relevant waters :(b)Fixed Date of intended commencement of operations :7. Date of cessation of operations
(a)Mobile Date of intended departure from relevant waters :(b)Fixed Intended date of cessation of operations :for which the installation was set-up8. Any other information.
Signature ...................................Name .......................................Designation ..............................Date .........................................FORM 2NOTICE OF ACCIDENT(See rule 11)Accident InformationName of Operator:
| Date of accident : |
Time : |
Hrs. |
| Accident Location : |
Type of Accident: |
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| Operation at the time of Accident : |
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| Field Name |
Block No. |
Name of Installation |
Brief details of Accident:Immediate action taken:(Tick those applicable)No. of persons injured/deceased:......................(fill in separate from for each injured/deceased person)Name of injured/deceased person (first/middle/last):Age (in yrs): Experience (in line/with operator): Yrs/yrsOccupation:Employer (tick one) Operator Contractor Shift Information (tick one) Contractor's name: morn.eve.night gen.Type of injury : Injured part of body : Injury severity level (tick one) high/medium-high/medium/medium-low/lowSequence leading to injury:Absence of injured person from duty-No. of days hours Dangerous Occurence(Type of dangerous occurrence) :Property Damage(Type of Machinary/Equipment) :
| Cost of Damage (Rs.) : |
Percentage of damage to Installation Cost (%) |
Other information as applicable (Please tick mark)Sketch Photo Preliminary Enquiry Report WithnessAccident Analysis (applicable for quarterly reporting)
| Immediate cause: |
Basic cause: |
Suggested corrective action:Review date for corrective action:Near miss Incident (applicable for quarterly reporting)Brief details of near miss incident:Suggested corrective action:Date and place:Signature, name and designation:FORM 3NOTICE CONCERNING PERSON SUCCUMBING TO INJURIES(See rule 11)1. Name of the operator :
2. Name of the offshore installation :
3. Particulars of fatality
(i)Date and time of accident :(ii)Date of submission of notice in Form 2 (enclose copy) :(iii)Date and time of death :(iv)Brief description of circumstances leading to death :Signature ......................................Name ............................................Designation ..................................Date...............................................