Notice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 1 of 13

Reproduction of this form is permitted. 

### DOT USE ONLY

U.S. Department of Transportation 

### ANNUAL REPORT FOR CALENDAR YEAR 20___ Initial Date

Submitted

Pipeline and Hazardous Materials 

### NATURAL AND OTHER GAS TRANSMISSION AND

GATHERING PIPELINE SYSTEMS Report Submission

Type

Safety Administration 

### Date Submitted

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a p enalty for failure to

comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless tha t collection of information displays a

current valid OMB Control Number. The OMB Control Number for this information collection is 2137

- 0522 . Public reporting for this collection of

information is estimated to be approximately 42 hours per response, including the time for reviewing instructions, gathering the data needed, and

completing and reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding

this burden estima te or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Coll ection

Clearance Officer, PHMSA, Office of Pipeline Safety (PHP

- 30) 1200 New Jersey Avenue, SE, Washington, D.C. 20590.

**Important:** Please read the separate instructions for completing this form before you begin. They clarify the information requested and provide

specific examples. If you do not have a copy of the instructions, you can obtain one from the PHMSA Pipeline Safety Commu nity Web Page

at http://www.phmsa.dot.gov/pipeline/library/forms

.

PART A

- OPERATOR INFORMATION DOT USE ONLY

1. OPERATOR’S 5 DIGIT IDENTIFICATION NUMBER (OPID)

/ / / / / / 2. NAME OF OPERATOR :

3. RESERVED 4. HEADQUARTERS ADDRESS :

Street Address

State: / / / Zip Code: / / / / / /

- / / / / /

5 . THIS REPORT PERTAINS TO THE FOLLOWING COMMODITY GROUP : (Select Commodity Group based on the predominant gas carried

and complete the report for that Commodity Group . File a separate report for each Commodity Group included in this OPID.)



###  Natural Gas

 Synthetic Gas

 Hydrogen Gas

 Propane Gas

 Landfill Gas

 Other Gas  Name of Other Gas ___________________

6

. RESERVED

7

. FOR THE DESIGNATED “ COMMODITY GROUP ” , THE PIPELINES AND/OR PIPELINE FACILITIES INCLUDED WITHIN THIS OPID ARE:

( Select one or both )



###  INT ERstate pipeline  L ist all of the States and OCS portions in which INT ERstate

pipelines and/or pipeline facilities included under this OPID exist : __, __, __, __, __, etc.

 INT RAstate pipeline  L ist all of the States in which INT RAstate pipelin es and/or pipeline

facilities included under this OPID exist: __, __, __, __, __, etc.Notice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 2 of 13

Reproduction of this form is permitted. 8

. RESERVED



### For the designated **Commodity Group**

**, PART**  **s B**  **and D**  **will be calculated based on the data entered in**

**Parts L**  **and P**  **respectively. Complete Part C one time**  **for all pipeline s and/or pipeline facilities** 

**– both** 

**I NT**  **ERstate and I NT**  **RAstate**

**- included**  **within this OPID** 

**.**

PART B

– TRANSMISSION PIPELINE HCA MILES

Number of HCA Miles



### Onshore Calc



### Offshore Calc

Total Miles Calc

PART C

- VOLUME TRANSPORTED IN TRANSMISSION

PIPELINES (ONLY) IN M ILLION SCF PER YEAR ( excludes

Transmission lines of Gas Distribution systems) 

###  Check this box and do not complet e PART C if this report only

includes gathering pipelines or t ransmission lines of g as d istribution

systems.



### Onshore Offshore

Natural Gas

Propane Gas

Synthetic Gas

Hydrogen Gas

Landfill Gas

Other Gas  Name: ____________________

PART D

- MILES OF PIPE BY MATERIAL AND CORROSION PR EVENTION STATUS

Steel c athodically

protected Steel c athodically

unprotected

Bare Coated Bare Coated Cast

Iron Wrought

Iron Plastic Composite 1 Other Total

Miles

Transmission

Onshore Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Offshore Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Subtotal Transmission Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Gathering

Onshore Type A Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Onshore Type B Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Offshore Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Subtotal Gathering Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Total Miles Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

1 

### Use of Composite pipe requires a PHMSA Special Permit or waiver from a State

PART E

- RESERVEDNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 3 of 13

Reproduction of this form is permitted. 

### For the designated **Commodity Group , c**  **omplete PARTs F**  **a nd**  **G one time for all I**  **NT ERstate**  **pipeline**

**facilities included**  **with in this OPID and multiple times as needed for**  **the designated Commodity Group**  **for**

**each State in which I NT**  **RAstate pipeline**  **facilities included**  **with in this OPID**  **exist**

**. Part F**  **“WITHIN AN HCA**

**SEGMENT” data and Part G**  **may be completed**  **only if HCA Miles in Part**  **L is greater than zero.** 

PARTs F and G

The data reported in these PARTs applies to: (select only one)

 Interstate pipelines/pipeline facilities

 Intrastate p ipelines/pipeline facilities in the State of /__/__/ (complete for each State)

PART F

- INTEGRITY INSPECTIONS CONDUCTED AND ACTIONS TAKEN BASED ON INSPECTION



### 1. MILEAGE INSPECTED IN CALENDAR YEAR USING THE FOLLOWING IN

- LINE INSPECTION (ILI) TOOLS

a. Corrosion or metal loss tools

b. Dent or deformation tools

c. Crack or long seam defect detection tools

d. Any other internal inspection tools , specify other tools :

e. Total tool mileage inspected in calendar year using in

- line inspection tools

. ( L ines a + b + c + d ) Calc

2. ACTIONS TAKEN IN CALENDAR YEAR BASED ON IN

- LINE INSPECTIONS

a. Based on ILI data, total number of anomalies excavated in calendar year because they met the operator’s

criteria for excavation.

b. Total number of anomalies repaired in calendar year that were identified by ILI based on the operator’s criteria

, both within a n HCA Segment and outside of an HCA S egment

.

c. Total n umber of conditions repaired WITHIN A N HCA SEGMENT m eeting the d efinition of: Calc

1. “ I mmediate repair condition s ” [19 2.933(d) (1) ]

2. “One

- year c ondition s ” [192.933(d) (2) ]

3. “Monitored conditions” [192.933(d)(3)]

4. Other “Scheduled conditions” [192.933(c)]

3. MILEAGE INSPECTED AND ACTIONS TAKEN IN CALENDAR YEAR BASED ON PRESSURE TESTING

a. Total mileage inspected by pressure testing in calendar year

.

b. Total number of pressure test failures (ruptures and leaks) repaired in calendar year, both within a n HCA

S egment and outside of a n HCA S egment

.

c . Total number of pressure test ruptures (complete failure of pipe wall) repaired in calendar year WITHIN A N HCA

SEGMENT

.

d . Total number of pressure test leaks (less than complete wall failure but including escape of test medium)

repaired in calendar year WITHIN A N HCA SEGMENT

.Notice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 4 of 13

Reproduction of this form is permitted. 

### (PART F continued)

4. MILEAGE INSPECTED AND ACTIONS TAKEN IN CALENDAR YEAR BASED ON DA ( Direct Assessment methods )

a. Total mileage inspected by each DA method in calendar year. Calc

1. ECDA

2. ICDA

3. SCCDA

b. Total number of anomalies identified by each DA method and repaired in calendar year based on the operator’s

criteria, both within a n HCA S egment and outside of a n HCA S egment

. Calc

1. ECDA

2. ICDA

3. SCCDA

c. Total n umber of conditions repaired in calendar year WITHIN A N HCA SEGMENT m eeting the d efinition of: Calc

1. “Immediate repair condition s ” [192.933(d)(1)]

2. “One

- year c ondition s ” [192.933(d)(2)]

3. “Monitored conditions” [192.933(d)(3)]

4. Other “Scheduled conditions” [192.933(c)]

5. MILEAGE INSPECTED AND ACTIONS TAKEN IN CALENDAR YEAR BASED ON OTHER INSPECTION TECHNIQUES

a. Total mileage inspected by inspection techniques other than those listed above in calendar year. Specify other

inspection technique (s) :

b. Total number of anomalies identified by other inspection techniques and repaired in calendar year based on the

operator’s criteria , both within a n HCA S egment and outside of a n HCA S egment

.

c. Total number of conditions repaired in calendar year WITHIN A N HCA SEGMENT meeting the definition of: Calc

1. “Immediate repair conditions” [192.933(d)(1)]

2. “One

- year conditions” [192.933(d)(2)]

3. “Monitored conditions” [192.933(d)(3)]

4. Other “Scheduled conditions” [192.933(c)]

6 . TOTAL MILEAGE INSPECTED (ALL METHODS) AND ACTIONS TAKEN IN CALENDAR YEAR

a. Total mileage inspected in calendar year

. (Lines 1.e + 3.a + 4.a .1 + 4.a.2 + 4.a.3 + 5.a ) Calc

b. Total number of anomalies repaired in calendar year both within an HCA Segment and outside of an HCA

Segment . (Lines 2.b + 3. b + 4.b .1 + 4.b.2 + 4.b.3 + 5.b) Calc

c. Total number of conditions repaired in calendar year WITHIN A N HCA SEGMENT . (Lines 2.c.1 + 2.c.2 + 2.c.3 +

2.c.4 + 3. c + 3. d + 4. c .1 + 4. c .2 + 4. c .3 + 4.c.4 + 5.c.1 + 5.c.2 + 5.c.3 + 5.c.4 ) Calc

d. Total number of actionable anomalies eliminated by pipe replacement in calendar year WITHIN AN HCA

SEGMENT:

e . Total number of a c tionable anomalies eliminated by pipe abandonment in calendar year WITHIN AN HCA

SEGMENT :

PART G

– MILES OF BASELINE ASSESSMENTS AND REASSESSMENTS COMPLETED IN CALENDAR YEAR ( HCA S egment miles

ONLY)

a

. Baseline assessment miles completed during the calendar year.

b. Reassessment miles completed during the calendar year.

c

. Total assessment and reassessment miles completed during the calendar year

. CalcNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 5 of 13

Reproduction of this form is permitted. 

### For the designated Commodity Group, complete PARTs H, I, J, K, L, M, P, Q, and R covering INTERstate

**pipeline facilities for each State in which I**  **NT ERstate systems exist within this OPID and again covering** 

**I NT**  **RAstate pipeline facilities**  **for each State in which I NT**  **RAstate systems exist within this OPID.**

PARTs H, I , J, K, L

, M , P, Q , and R

The data reported in these PARTs applies to: **(select only one)**

 Interstate pipelines/pipeline facilities in the State of /__/__/ (complete for each State)

 Intrastate Pipelines/pipeline facilities in the State of /__/__/ (complete for each State)

PART H

- MILES OF TRANSMISSION PIPE BY NOMINAL PIPE SIZE (NPS)



### Onshore NPS 4

or less 6 8 10 12 14 16 18 20

22 24 26 28 30 32 34 36 38

4 0 42 44 46 48 5 2 56 58 and

over

Other Pipe Sizes

Not Listed

Size: __ Miles: ________

Add Sizes as needed

Calc Total Miles of Onshore Pipe

- Transmission



### O ff shore NPS 4

or less 6 8 10 12 14 16 18 20

22 24 26 28 30 32 34 36 38

40 42 44 46 48 5 2 56 58 and

over

Other Pipe Sizes

Not Listed

Size: __ Miles: ________

Add Sizes as needed

Calc Total Miles of O ffshore Pipe

- TransmissionNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 6 of 13

Reproduction of this form is permitted. PART I

- MILES OF GATHERING PIPE BY NOMINAL PIPE SIZE (NPS)



### O n shore

Type A NPS 4

or less 6 8 10 12 14 16 18 20

22 24 26 28 30 32 34 36 38

40 42 44 46 48 5 2 56 58 and

over

Other Pipe Sizes

Not Listed

Size: __ Miles: ________

Add Sizes as needed

Calc Total Miles of O nshore Type A Pipe

- Gathering



### O n shore

Type B NPS 4

or less 6 8 10 12 14 16 18 20

22 24 26 28 30 32 34 36 38

40 42 44 46 48 5 2 56 58 and

over

Other Pipe Sizes

Not Listed

Size: __ Miles: ________

Add Sizes as needed

Calc Total Miles of O nshore Type B Pipe

- Gathering



### O ff shore NPS 4

or less 6 8 10 12 14 16 18 20

22 24 26 28 30 32 34 36 38

40 42 44 46 48 5 2 56 58 and

over

Other Pipe Sizes

Not Listed

Size: __ Miles: ________

Add Sizes as needed

Calc Total Miles of O ffshore

- GatheringNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 7 of 13

Reproduction of this form is permitted. PART J

– MILES OF PIPE BY DECADE INSTALLED

Decade Pipe Installed Unknown Pre

- 19 40 1940

- 1949 1950

- 1959 1960

- 1969 1970

- 1979 1980

- 1989



### Transmission

Onshore

Offshore

Subtotal Transmission Calc Calc Calc Calc Calc Calc Calc



### Gathering

Onshore Type A

Onshore Type B

Offshore

Subtotal Gathering Calc Calc Calc Calc Calc Calc Calc

Total Miles Calc Calc Calc Calc Calc Calc Calc

Decade Pipe Installed 1990

- 1999 2000

- 2009 2010

- 2019 Total Miles



### Transmission

Onshore Calc



### Offshore Calc

Subtotal Transmission Calc Calc Calc Calc



### Gathering

Onshore Type A Calc



### Onshore Type B Calc



### Offshore Calc

Subtotal Gathering Calc Calc Calc Calc

Total Miles Calc Calc Calc CalcNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 8 of 13

Reproduction of this form is permitted. PART K

- MILES OF TRANSMISSION PIPE BY SPECIFIED MINIMUM YIELD STRENGTH



### ONSHORE CLASS LOCATION

Total Miles

Class I Class 2 Class 3 Class 4



### Steel pipe Less than

20% SMYS Calc



### Steel pipe Greater than or

equal to 20% SMYS but less

than30% SMYS Calc



### Steel pipe Greater than or

equal to 30% SMYS but less

than or equal to 40% SMYS Calc



### Steel pipe Greater than 40%

SMYS but less than or equal to

50% SMYS Calc



### Steel pipe Greater than 50%

SMYS but less than or equal to

60% SMYS Calc



### Steel pipe Greater than 60 %

SMYS but less than or equal to

72% SMYS Calc



### Steel pipe Greater than 72%

SMYS but less than or equal to

80% SMYS Calc



### Steel pipe Greater than 80%

SMYS Calc



### Steel pipe Unknown percent of

SMYS Calc



### All Non

- Steel pipe Calc



### Onshore Totals Calc Calc Calc Calc Calc



### OFFSHORE Class I



### Steel pipe Less than or equal to

50% SMYS

Steel pipe Greater than 50%

SMYS but less than or equal to

72% SMYS

Steel pipe Greater than 72%

SMYS

Steel pipe Unknown percent of

SMYS

All non

- steel pipe

Offshore Total Calc



### Total Miles Calc Calc Calc Calc CalcNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 9 of 13

Reproduction of this form is permitted. PART L

- MILES OF PIPE BY CLASS LOCATION

Class Location Total

Class Location

Miles HCA Miles

Class I Class 2 Class 3 Class 4



### Transmission

Onshore Calc from Part K Calc from Part K Calc from Part K Calc from Part K Calc



### Offshore Calc from Part K Calc

Subtotal Transmission Calc Calc Calc Calc Calc Calc



### Gathering

Onshore Type A Calc



### Onshore Type B Calc



### Offshore Calc

Subtotal Gathering Calc Calc Calc Calc Calc

Total Miles Calc Calc Calc Calc Calc CalcNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 10 of 13

Reproduction of this form is permitted. PART M

– FAILURES, LEAKS, AND REPAIRS

PART M 1

– ALL LEAKS ELIMINATED/REPAIRED IN CALENDAR YEAR ; FAILURES IN HCA SEGMENTS IN CALENDAR YEAR



### Cause Transmission Leaks and Failures Gathering Leaks

Leaks Failures

in HCA

Segments Onshore

Leaks Offshore

Leaks Onshore Leaks Offshore Leaks

HCA Non

- HCA HCA Non

- HCA Type

A Type

B



### External Corrosion

Internal Corrosion

Stress Corrosion

Cracking

Manufacturing

Construction

Equipment

Incorrect Operations

Third Party Damage/Mechanical Damage

Excavation Damage

Previous Damage (due

to Excavation Activity)

Vandalism (includes all

Intentional Damage)

Weather Related/Other Outside Force

Natural Force Damage

(all)

Other Outside Force

Damage (excluding

Vandalism and all

Intentional Damage )

Other

Total Calc Calc Calc Calc Calc Calc Calc Calc

PART M 2

– KNOWN SYSTEM LEAKS AT END OF YEAR SCHEDULED FOR REPAIR



### Transmission Gathering

PART M 3

– LEAKS ON FEDERAL LAND OR OCS REPAIRED OR SCHEDULED FOR

REPAIR



### Transmission Gathering

Onshore Onshore Type A

Onshore Type B

OCS OCS

Subtotal Transmission Calc Subtotal Gathering Calc

Total CalcNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 11 of 13

Reproduction of this form is permitted. PART P

- MILES OF PIPE BY MATERIAL AND CORROSION PR EVENTION STATUS

Steel cathodically

protected Steel cathodically

unprotected

Bare Coated Bare Coated Cast

Iron Wrought

Iron Plastic Composite 1 Other 2 Total

Miles

Transmission

Onshore Calc

Offshore Calc

Subtotal Transmission Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Gathering

Onshore Type A Calc

Onshore Type B Calc

Offshore Calc

Subtotal Gathering Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

Total Miles Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc

1 

### Use of Composite pipe requires a PHMSA Special Permit or waiver from a State

2 

### specify Other material(s):



### Part Q

- Gas Transmission Miles by §192.619 MAOP Determination Method

(a)(1) Total (a)(1)

Incomplete

Rec or ds (a)(2) Total (a)(2)

Inc omplete

Rec or ds (a)(3) Total (a)(3)

Inc omplete

Rec or ds (a)(4) Total (a)(4)

Inc omplete

Rec or ds (c)

Total (c)

Inc omplete

Rec or ds (d)

Total (d)

Inc omplete

Rec or ds Other 1

Total Other

Inc omplete

Rec or ds

Class 1 (in HCA)

Class 1 (not in HCA)

Class 2 (in HCA)

Cl ass 2 (not in HCA)

Class 3 (in HCA)

Class 3 (not in HCA)

Class 4 (in HCA)

Class 4 (not in HCA)

Total Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc Calc



### Grand Total Calc



### Sum of Total row for all “ Inc omplete Rec or ds” columns Calc

1 

### Specify Other method(s):Notice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 12 of 13

Reproduction of this form is permitted. 

### Part R

– Gas Transmission Miles by Pressure Test (PT) Range and Internal Inspection

PT ≥ 1.25 MAOP 1.25 MAOP > PT ≥ 1.1 MAOP PT < 1.1 or No PT

Location Miles Internal

Inspection ABLE Miles Internal

Inspection

NOT ABLE Miles Internal

Inspection ABLE Miles Internal

Inspection

NOT ABLE Miles Internal

Inspection ABLE Miles Internal

Inspection

NOT ABLE



### Class 1 in HCA

Class 2 in HCA

Class 3 in HCA

Class 4 in HCA

in HCA subTotal Calc Calc Calc Calc Calc Calc

Class 1 not in HCA

Class 2 not in HCA

Class 3 not in HCA

Class 4 not in HCA

not in HCA subTotal Calc Calc Calc Calc Calc Calc

T otal Calc Calc Calc Calc Calc Calc

PT ≥ 1.25 MAOP Total Calc Total Miles Internal Inspection ABLE Calc

1.25 MAOP > PT ≥ 1.1 Calc Total Miles Internal Inspection NOT ABLE Calc

PT < 1.1 or No PT Total Calc Grand Total Calc

Grand Total CalcNotice: This report is required by 49 CFR Part 191. Failure to report may result in a civil penalty not to exceed $100,000 for each violation Form Approved

for each day the violation continues up to a maximum of $1,000,000 as provided in 49 USC 60122. OMB No. 2137

- 0522

Expires: 10/31/2016

Form PHMSA F 7100.2

- 1 ( r ev 10

- 2014 ) Pg. 13 of 13

Reproduction of this form is permitted. 

### For the designated **Commodity Group , c**  **omplete PART N**  **one time for all of the pipelines and/or pipeline** 

**facilities included**  **with in this OPID**  **, and then also PART O**  **if any**  **gas transmission pipeline facilities** 

**included within this OPID**  **have Part L HCA mile value greater than zero** 

**.**

PART N

- PREPARER SIGNATURE

Preparer's Name(type or print) /__/__/__/

- /__/__/__/

- /__/__/__/__/

Telephone Number

Preparer's Title

Preparer's E

- mail Address

PART O

- CERTIFYING SIGNATURE (applicable to PARTs B, F

, G , and M 1 )

/__/__/__/

- /__/__/__/

- /__/__/__/__/

Telephone Number

Senior Executive Officer’s name certifying the information in PARTs B, F

, G

, and M as required by

49 U.S.C. 60109(f)

Senior Executive Officer’s title certifying the information in PARTs B, F

, G, and M as required by

49 U.S.C. 60109(f)

Senior Executive Officer’s E

- mail Address