Form BSEE-0131 "Performance Measures Data"

What Is Form BSEE-0131?

This is a legal form that was released by the U.S. Department of the Interior - Bureau of Safety and Environmental Enforcement on November 1, 2019 and used country-wide. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on November 1, 2019;
  • The latest available edition released by the U.S. Department of the Interior - Bureau of Safety and Environmental Enforcement;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form BSEE-0131 by clicking the link below or browse more documents and templates provided by the U.S. Department of the Interior - Bureau of Safety and Environmental Enforcement.

ADVERTISEMENT
ADVERTISEMENT

Download Form BSEE-0131 "Performance Measures Data"

1424 times
Rate (4.6 / 5) 81 votes
U.S. Department of the Interior
OMB Control Number 1014-0017
Bureau of Safety and Environmental Enforcement (BSEE)
OMB Approval Expires 11/30/2021
P
M
D
ERFORMANCE
EASURES
ATA
Provide Data on an Annual Basis for the Previous Calendar Year by March 31 of Each Year
Company Name(s)
BSEE Region
Operator Code(s)*
Calendar Year ____________
Contact Name
Email Address
Telephone
Fax
Date
PRODUCTION
DRILLING**
CONSTRUCTION
SAFETY
OPERATIONS
OPERATIONS
OPERATIONS
st
A. No. of Company Employee
1
Qtr ___________
Non-DART Recordable
nd
Injuries/Illnesses***
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr ___________
______________
_______________
st
B. No. of Contract Employee
1
Qtr ___________
Non-DART Recordable
nd
Injuries/Illnesses***
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr ___________
______________
_______________
st
C. No. of Company Employee
1
Qtr ___________
DART Injuries/Illnesses****
nd
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr ___________
______________
_______________
st
D. No. of Contract Employee
1
Qtr ___________
DART Injuries/Illnesses****
nd
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr___________
______________
_______________
BSEE
Form BSEE-0131
(Nov, 2019 - Replaces all previous versions of this form that may not be used.)
Page 1 of 2
U.S. Department of the Interior
OMB Control Number 1014-0017
Bureau of Safety and Environmental Enforcement (BSEE)
OMB Approval Expires 11/30/2021
P
M
D
ERFORMANCE
EASURES
ATA
Provide Data on an Annual Basis for the Previous Calendar Year by March 31 of Each Year
Company Name(s)
BSEE Region
Operator Code(s)*
Calendar Year ____________
Contact Name
Email Address
Telephone
Fax
Date
PRODUCTION
DRILLING**
CONSTRUCTION
SAFETY
OPERATIONS
OPERATIONS
OPERATIONS
st
A. No. of Company Employee
1
Qtr ___________
Non-DART Recordable
nd
Injuries/Illnesses***
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr ___________
______________
_______________
st
B. No. of Contract Employee
1
Qtr ___________
Non-DART Recordable
nd
Injuries/Illnesses***
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr ___________
______________
_______________
st
C. No. of Company Employee
1
Qtr ___________
DART Injuries/Illnesses****
nd
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr ___________
______________
_______________
st
D. No. of Contract Employee
1
Qtr ___________
DART Injuries/Illnesses****
nd
2
Qtr ___________
_____________
______________
rd
3
Qtr ___________
_____________
_______________
th
4
Qtr___________
______________
_______________
BSEE
Form BSEE-0131
(Nov, 2019 - Replaces all previous versions of this form that may not be used.)
Page 1 of 2
PRODUCTION
DRILLING**
CONSTRUCTION
SAFETY
OPERATIONS
OPERATIONS
OPERATIONS
st
E. Company Employee
1
Qtr
Hours Worked
nd
2
Qtr
_____________
____________
________________
rd
3
Qtr
_____________
_____________
________________
th
4
Qtr
_____________
_____________
________________
st
F. Contract Employee 1
Qtr
Hours Worked
nd
2
Qtr
___________
___________
_______________
rd
3
Qtr
____________
____________
_______________
th
4
Qtr
____________
_____________
_______________
ENVIRONMENT
G. No. of EPA NPDES Noncompliances
[No longer being requested; data will instead be obtained from EPA
ECHO Database]
H. For Oil Spills < 1 bbl
1. No. of Spills
2. 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
BSEE
Form BSEE-0131
(Nov, 2019 - Replaces all previous versions of this form that may not be used.) Page 2 of 2
Page of 2