Lessons Learned Short Form

Lessons Learned
Name

First NameLast Name
Email
example@example.com
Organization
Phone
Date of Finding*

MonthDayYear
Date
Time of Day*

Hour Minutes

AM/PM Option
What is the source of the Lesson Learned?*

Regulatory AuditInternal AuditInternal QC FindingInternal QA FindingNear Miss / Good CatchPipeline Safety TailboardPipeline Quality TailboardSafety AlertPipeline Safety Incidents
Type of Asset Involved*

MainServiceBridge CrossingRail CrossingWater CrossingsValve (excluding regulator/control valves)Regulator/Control ValvesMeterScrapper/Pig TrapOdorization SystemFilter/Strainer/SeparatorDehydration/Drier/Treater/ScrubberPulsation BottleCooler or HeaterRepair Sleeve or ClampHot Tap EquipmentTap FittingFlange Assembly, including gasketsTubing Assembly, including gasketsTubing, including fittingsIntrumentation and ElectricalCompressorOutside MeterInside MeterInside PipingOther
Lesson Learned Category*

Overpressure and/or Unintended Loss of PressureUpratesDamage Prevention (Excavation, Weather and Outside Force)Pipe Joining / Fusion WorkmanshipLeak Detection (Including reduction and minimization)Materials, Equipment and ToolsWelding Practices Work Zone and Excavation SafetyCorrosion Control Customer Meter / Regulator Installation and Inspection Valve Operations and MaintenanceGate/Regulator Station Operations and Maintenance
Lesson Learned Category_old

Overpressure and/or Unintended Loss of PressureUpratesDamage Prevention (Excavation, Weather and Outside Force)Pipe Joining / Fusion WorkmanshipLeak Detection (Including reduction and minimization)Materials, Equipment and ToolsWelding Practices Work Zone and Excavation SafetyCorrosion Control Customer Meter / Regulator Installation and Inspection Valve Operations and MaintenanceGate/Regulator Station Operations and Maintenance
What kind of work was being conducted?*

ConstructionOperations & Maintenance
Construction
Type of Construction*

MaintenanceNewReplacementGate/Regulator Station ConstructionCustomer Meter/Regulator Set
Operations and Maintenance
Description of event*
Root Cause and Contributing Factors*
Root Cause(s)*
Key Corrective Actions*
Key Lessons Learned*
Provide image 1

Cancelof
Provide image 2

Cancelof
Should be Empty:

Lessons Learned

Construction

Operations and Maintenance