Report of an Oil and Gas Incident (ROGI) Form
Report of an Oil and Gas Incident (ROGI) Form - Interim
version
Guidance
Who should use this form?
This form should be used from 19th July 2015, by offshore oil and gas installation duty
holders with Safety Cases accepted under the 2015 Safety Case Regulations. Other offshore
installation duty holders, pipeline operators, onshore borehole operators etc. should continue
to report incidents by using OIR9b, OIR8 and OIR12 forms. Petroleum Operations Notice
(PON1) notifications are not affected and should be submitted as usual.
What is the Form?
Reporting of incidents is required in the UK by various legislation, including: The Reporting of
Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR); Regulation 9 of
the Offshore Installations and Wells (Design and Construction, etc.) Regulations 1996 (DCR)
and Regulation 21B of the Offshore Installations and Pipeline Works (Management and
Administration) Regulations 1995 (MAR). There is also a voluntary reporting scheme for
reporting data on offshore hydrocarbon releases using the OIR12 form. Additionally,
European Commission Implementing Regulation (EU) No 1112/2014 now also applies in the
UK. The EU reporting requirements is very specific about how offshore major hazard
incidents must be reported so that a common format is adopted by EU Member States. The
Implementing Regulation requirements overlap with RIDDOR, DCR and MAR. It also makes
compulsory some of the previously voluntary hydrocarbon release reporting criteria.
The ROGI form is a tool to enable duty holders to comply with these separate regulatory
reporting requirements.
It integrates existing RIDDOR, DCR, MAR, and voluntary
requirements with those arising from the EU Offshore Safety Directive and the Implementing
Regulation. Submitting a ROGI form removes the need to submit existing RIDDOR forms
OIR9b, and the OIR8 and OIR12.
This version of the form is an interim step towards an integrated, online reporting tool that will
be available for reporting of incidents by all users. When available, the online tool will replace
the interim version and the existing OIR9b, OIR8 and OIR12 reporting forms.
The ROGI form is designed to show what must be reported and which particular regulations
or voluntary criteria apply. The form has several parts and completion of more than one
part will often be required for a single incident, but it is unlikely that all parts will need to
be completed. The form layout is intended to guide users toward the parts they need to
complete. The parts are:
Part A: Unintended Release of Oil, Gas or Hazardous Substance (ignited or not), Fires and
Explosions
Part B: Dangerous Occurrence in relation to a Well
Part C: Failure of a Safety & Environmental Critical Element
Part D: Danger to the Integrity of an Installation, Collapses, Equipment Failure, Weather
Damage, Seabed Subsidence
Part E: Vessel Collisions, or Potential Collisions, with an installation
Part F: Aircraft Collisions or Potential Collisions with an Installation
Part G: Fatalities
Part H: Serious Injuries
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Report of an Oil and Gas Incident (ROGI) Form
Part I: Partial or Complete Evacuation of Personnel
Part J: Major Environmental Incident arising from a Safety Incident, (Note: PON1 reporting is
still a requirement. The ROGI form is additional in the event of a Major environmental
incident)
Part K: Other Reportable Injuries, Diseases and Dangerous Occurrences
Over Seven day injuries;









Occupational Diseases
Exposure to Carcinogens, Mutagens and Biological Agents
Diseases Offshore; Diving Operations; Dropped Objects
Fall into Water
Lifting Equipment
Biological Agents
Radiation
Breathing Apparatus
Pipelines or Pipeline Works
Part L: Death or Loss of a Person Pursuant to MAR Regulation 21B. (Note: although
provided within the ROGI Form this must be printed and sent to the Registrar
General of Shipping and Seamen)
Worked example
A hydrocarbon release was caused by the failure of a safety and environmental critical
element and as a consequence you decided to partially evacuate the installation. To report
this scenario using the ROGI form, you are required to undertake four stages:
1. Complete your details at the start of the form (Page 4)
This is the detail which includes where incident happened, when it happened, who is
reporting etc.
2. Identify which parts of the form are relevant to your circumstances by ticking the
boxes provided beside the various legislative reporting requirements.
In the example scenario it is likely that you will select the following Event
Categorisations in the Criteria parts:
Part A: Criteria: Unintended Release of Oil, Gas or Hazardous Substance
(ignited or not), Fires and Explosions



Implementing Regulation. Section A
RIDDOR 2013, Part 6 Regulation. 75
OIR 12 Voluntary HCR Release
Part C: Criteria: Failure of a Safety & Environmental Critical Element

Implementing Regulation Section C
Part I: Criteria: Partial or complete evacuation of personnel


Implementing Regulation. I
RIDDOR Part 6 Regulation. 86
3. Turn to the identified Parts Criteria and complete the Detailed Reports as required.
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Report of an Oil and Gas Incident (ROGI) Form
Part A: Detailed Report: Unintended Release of Oil, Gas or Hazardous
Substance (ignited or not), Fires and Explosions
Part C: Detailed Report: Failure of a Safety & Environmental Critical
Element
Part I: Detailed Report: Partial or complete evacuation of personnel
4. Return Form via email to: osdr.reporting@hse.gsi.gov.uk
Note:
i.
ii.
Part A of the form has mandatory and voluntary reporting requirements. The
voluntary reporting detail within the form replaces the details currently provided via
the OIR12 arrangements. Some of the previous voluntary reporting details within the
OIR12 are now a mandatory requirement of the EU Offshore Directive. The voluntary
reporting is identifiable by (Voluntary). Reporters are, however, strongly encouraged
to complete these sections in order to maximise the completeness of the resulting
incident database and the knowledge that can thereby be obtained for the benefit of
the industry.
Use the Navigation Pane to navigate around the Microsoft Word 2010 form. To view
this feature on the left hand side of your form, press Ctrl+F, or select the View tab and
select the Navigation Pane check box in the ‘Show’ section on the ribbon.
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Report of an Oil and Gas Incident (ROGI) Form
Event Date and Time (hh:mm)
Enter event date
Enter event time hh:mm
Version
☐
Final Version
☐
Interim Version
External or Internal waters
☐
External
☐
Internal
Your Details
Details of the location and the person reporting the event
Operator / owner
Enter operator/owner
Name of the installation
Enter installation name
Type of installation
Production Type
Choose production type
Occupancy Type
Choose occupancy type
Function Type
Choose function type
Structure Type
Choose structure type
Field name / code (if relevant)
Enter name/code
Number of Persons on board
(POB) at time of event
Enter number of persons on board
Position of the Installation,
vessel, pipeline
Quadrant
Latitude
Longitude
Depth of Water (metres)
Details of the module / area on
the installation / vessel where
the incident occurred
Enter details
Where on the site did the
dangerous occurrence happen?
Enter department
What type of work was being
undertaken at the time of the
event?
Enter type of work
Main Industry
Enter main industry
Main Activity
Enter main activity
Sub Activity
Enter sub activity
Name of the reporting person
Enter name of reporting person
Role of the reporting person
Enter role of reporting person
Telephone Number
Enter quadrant
Enter latitude
Enter longitude
Enter depth
Enter phone number
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Report of an Oil and Gas Incident (ROGI) Form
E-mail address
Enter email address
Address Line 1
Enter address line 1
Address Line 2
Enter address line 2
Address Line 3
Enter address line 3
Town
Enter name of town
County
Post Code
Description of circumstances,
consequences of event &
emergency response
Enter county
Enter postcode
Enter description
The Competent Authority shall further complete this section.
Relates to requirement as detailed in the Implementation Regulation Section (A/B/C/D/E/F)
Is this considered to be a major
accident?
Give justification
☐
Yes
☐
No
Enter justification.
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Report of an Oil and Gas Incident (ROGI) Form
Event Categorisation
What type of event is being reported? (More than one option A to L may be applicable)
Please select all relevant parts and within each part the relevant legislation reporting against.
A single incident may result in multiple parts to be completed. If any boxes are selected in this
form then the detailed report of each selected section needs to be completed.
Part A Criteria
Unintended Release of Oil, Gas or Hazardous Substance (ignited or not),
Fires and Explosions
Implementing Regulation No.1112/2014 Section A: Unintended release of oil, gas or other hazardous
substances, whether or not ignited
Unintended release of oil, gas or other hazardous substances, whether or not ignited:
1.
2.
3.
Any unintentional release of ignited gas or oil on or from an offshore
installation;
The unintentional release on or from an offshore installation of;
a. not ignited natural gas or evaporated associated gas if mass released ≥
1kg
b. not ignited liquid of petroleum hydrocarbon if mass released ≥ 60 kg;
The unintentional release or escape of any hazardous substance, for which the
major accident risk has been assessed in the report on major hazards, on or
from an offshore installation, including wells and returns of drilling additives
☐
RIDDOR 2013, Part 6 Dangerous Occurrences which are reportable in respect of an offshore workplace
75. - Release of petroleum hydrocarbon
The unintentional release of petroleum hydrocarbon on or from an offshore installation
which
a) results in
i.
a fire or explosion; or
ii.
the taking of action to prevent or limit the consequences of a potential fire or
explosion; or
☐
b) could cause a specified injury to, or the death of, any person.
76. - Fire or explosion
Any fire or explosion at an offshore installation, other than one caused by the release of
petroleum hydrocarbon, which results in the stoppage of plant or the suspension of normal
work.
☐
77. - Release or escape of dangerous substances
The unintentional or uncontrolled release or escape of any substance (other than
petroleum hydrocarbon) on or from an offshore installation which could cause a significant
risk of personal injury to any person.
☐
The unintentional release from a pipeline within the 500 metre zone of an installation
☐
OIR12 Voluntary HCR Release. (Voluntary)
The UK offshore industry has, since 1992, voluntarily notified the regulator of Hydrocarbon releases which are
in addition to legislative requirements. This is as a result of taking forward recommendation 39 of the Cullen
Report published in 1990, following the Piper Alpha disaster in 1988. This reporting arrangement benefits both
industry and the regulator to determine trends and for the purpose of carrying out quantified risk assessment.
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Report of an Oil and Gas Incident (ROGI) Form
Part B Criteria
Dangerous Occurrence in Relation to a Well
Implementing Regulation No. 1112/2014 Section B
Loss of well control requiring actuation of well control equipment, or failure of a well barrier
requiring its replacement or repair &
1. Any blowout, regardless of the duration
2. The coming into operation of a blowout prevention or diverter system to control
flow of well-fluids;
3. The mechanical failure of any part of a well, whose purpose is to prevent or limit
the effect of the unintentional release of fluids from a well or a reservoir being
drawn on by a well, or whose failure would cause or contribute to such a release.
4. The taking of precautionary measures additional to any already contained in the
original drilling programme where a planned minimum separation distance
between adjacent wells was not maintained.
☐
RIDDOR 2013, Schedule 2 Dangerous Occurrences Part 1 (General)
20. - Wells
In relation to a well (other than a well sunk for the purpose of the abstraction of water)
(a) a blow-out (which includes any uncontrolled flow of well-fluids from a well);
(b) the coming into operation of a blow-out prevention or diversion system to control
flow of well-fluids where normal control procedures fail;
(c) the detection of hydrogen sulphide at a well or in samples of well-fluids where the
responsible person did not anticipate its presence in the reservoir drawn on by the
well;
(d) the taking of precautionary measures additional to any contained in the original
drilling programme where a planned minimum separation distance between
adjacent wells was not maintained; or
(e) the mechanical failure of any part of a well whose purpose is to prevent or limit the
effect of the unintentional release of fluids from a well or a reservoir being drawn
on by a well, or whose failure would cause or contribute to such a release.
☐
NB: an unintentional hydrocarbon release from a well as a result from the above should
also be reported in Section A of this form.
Part C Criteria
Failure of a Safety & Environmental Critical Element
Implementing Regulation No. 1112/2014 Section C
Failure of a safety and environmental critical element.
☐
Any loss or non-availability of a SECE requiring immediate remedial action.
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Report of an Oil and Gas Incident (ROGI) Form
Part D Criteria
Danger to the Integrity of an Installation, Collapses, Equipment Failure,
Weather Damage, Seabed Subsidence
Implementing Regulation Section D
Significant loss of structural integrity, or loss of protection against the effects of fire or
explosion, or loss of station keeping in relation to a mobile installation:
Any detected condition that reduces the designed structural integrity of the
installation, including stability, buoyancy and station keeping, to the extent that it
requires immediate remedial action.
☐
RIDDOR 2013, Schedule 2 Dangerous Occurrences Part 6
78. - Collapses
Any unintentional collapse or partial collapse of any offshore installation or of any plant on
an offshore installation which jeopardises the overall structural integrity of the installation.
☐
79. - Equipment
☐
The failure of equipment required to maintain a floating offshore installation on station
which could cause a specified injury to, or the death of, any person.
81. - Weather damage
☐
Any damage to or on an offshore installation caused by adverse weather conditions and
which could cause a specified injury to, or the death of, any person.
84. - Subsidence or collapse of seabed
☐
Any subsidence or collapse of the seabed likely to affect the foundations or the overall
structural integrity of an offshore installation.
85. - Loss of stability or buoyancy
☐
Any incident which causes the loss of stability or buoyancy of a floating offshore
installation.
Design and Construction Regulations (DCR) 1996
Reporting of danger to an installation Regulation 9
(1) The duty holder shall ensure that, within 10 working days after the appearance of
evidence of a significant threat to the integrity of an installation, a report is made to the
Executive in writing identifying such threat and specifying any action taken or to be taken to
avert it.
(2) Paragraph (1) shall not apply to anything of which [the Reporting of Injuries, Diseases
and Dangerous Occurrences Regulations 2013] require a report to be made.
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Report of an Oil and Gas Incident (ROGI) Form
Part E Criteria
Vessel Collisions, or Potential Collisions, with an Installation
Implementing Regulation No. 1112/2014 Section E
Vessels on collision course and actual vessel collisions with an offshore installation:
Any collision, or potential collision, between a vessel and an offshore installation which
has, or would have, enough energy to cause sufficient damage to the installation and/or
vessel, to jeopardise the overall structural or process integrity.
☐
RIDDOR 2013 Schedule 2 Dangerous Occurrences Part 6
82. - Collisions
☐
Any collision between a vessel or aircraft and an offshore installation which causes
damage to the installation, the vessel or the aircraft.
83. - Collisions
Any occurrence with the potential for a collision between a vessel and an offshore
installation where, had a collision occurred, it might have jeopardised the overall structural
integrity of the installation.
☐
Part F Criteria
Aircraft Collisions or Potential Collisions with an Installation
Implementing Regulation No. 1112/2014 – Section F
Helicopter Accidents, on or near offshore installations. Helicopter incidents are reported
under CAA regulations. If a helicopter accident occurs in relation to Directive 2013/30/EU,
section F shall be completed
☐
RIDDOR 2013 Schedule 2 Dangerous Occurrences Part 6
82. - Collisions
☐
Any collision between a vessel or aircraft and an offshore installation which causes
damage to the installation, the vessel or the aircraft.
Part G Criteria
Fatalities
Implementing Regulation No. 1112/2014 Section G
Any fatal accident to be reported under the requirements of Directive 92/91/EEC
“The employer shall, without delay report any serious and/or fatal occupational accidents
and situations of serious danger to the competent authorities”
☐
RIDDOR 2013, Work-related fatalities
6.
☐
1) Where any person dies as a result of a work-related accident, the responsible
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Report of an Oil and Gas Incident (ROGI) Form
person must follow the reporting procedure.
2) Where any person dies as a result of occupational exposure to a biological agent,
the responsible person must follow the reporting procedure.
3) Where an employee has suffered an injury reportable under regulation 4 which is a
cause of his death within one year of the date of the accident, the employer must
notify the relevant enforcing authority of the death in an approved manner without
delay, whether or not the injury has been reported under regulation 4.
This regulation is subject to regulations 14 and 15, and does not apply to a self-employed
person who suffers a fatal accident or fatal exposure on premises controlled by that selfemployed person.
RIDDOR 2013, Schedule 1 Part 1 Injuries, fatalities and dangerous occurrences
1.
(1) Where required to follow the reporting procedure by regulation 4, 5, 6 or 7 (except
in relation to a mine or quarry), the responsible person must—
(a) notify the relevant enforcing authority of the reportable incident by the quickest
practicable means without delay; and
(b) send a report of that incident in an approved manner to the relevant enforcing
authority within 10 working days of the incident.
☐
Note: Consider if there is requirement to also complete Section L Form to be Completed in
respect of the death or loss of a person pursuant to Regulation 21B – Offshore Installations
and Pipelines Works (Management and Administration) Regulations 1995
Part H Criteria
Serious Injuries
Implementing Regulation No. 1112/2014 Section H
Any serious injuries to five or more persons in the same accident to be reported under the
requirements of Directive 92/91/EEC
“The employer shall, without delay report any serious and/or fatal occupational accidents
and situations of serious danger to the competent authorities”
☐
RIDDOR Non-fatal injuries to workers
4.
1) Where any person at work, as a result of a work related accident suffers
(a) any bone fracture diagnosed by a registered medical practitioner, other
than to a finger, thumb or toe;
(b) amputation of an arm, hand, finger, thumb, leg, foot or toe;
(c) any injury diagnosed by a registered medical practitioner as being likely to
cause permanent blinding or reduction in sight in one or both eyes;
(d) any crush injury to the head or torso causing damage to the brain or
internal organs in the chest or abdomen;
(e) any burn injury (including scalding) which:
i. covers more than 10% of the whole body’s total surface area; or
ii. causes significant damage to the eyes, respiratory system or other
vital organs;
(f) any degree of scalping requiring hospital treatment;
(g) loss of consciousness caused by head injury or asphyxia; or
(h) any other injury arising from working in an enclosed space which:
i. leads to hypothermia or heat-induced illness; or
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Report of an Oil and Gas Incident (ROGI) Form
ii. requires resuscitation or admittance to hospital for more than 24
hours, the responsible person must follow the reporting procedure.
RIDDOR 2013, Schedule 1 Part 1 Injuries, fatalities and dangerous occurrences
1.
(1) Where required to follow the reporting procedure by regulation 4, 5, 6 or 7 (except
in relation to a mine or quarry), the responsible person must—
(a) notify the relevant enforcing authority of the reportable incident by the
quickest practicable means without delay; and
☐
send a report of that incident in an approved manner to the relevant enforcing authority
within 10 working days of the incident. (a) (b)
Part I Criteria
Partial or Complete Evacuation of Personnel
Implementing Regulation No. 1112/2014 I.
Any evacuation of personnel:
Any unplanned emergency evacuation of part of or all personnel as a result of, or where
there is a significant risk of a major accident
☐
RIDDOR 2013, Dangerous Occurrences, Schedule 2 Part 6
86. - Evacuation
☐
The partial or complete evacuation of an offshore installation in the interests of safety
Part J Criteria
Major Environmental Incident arising from a Safety Incident.. (Note: PON
1 reporting is still a requirement. The ROGI form is additional in the
event of a Major environmental incident)
Implementing Regulation No 1112/2014: Section J : A major environmental incident
Any major environmental incident as defined in Article 2.1.d and Article 2.37 of Directive
2013/30/EU
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Report of an Oil and Gas Incident (ROGI) Form
Part K Criteria
Other Reportable Injuries, Diseases and Dangerous Occurrences (Over
Seven day injuries; Occupational Diseases; Exposure to Carcinogens,
Mutagens and Biological Agents; Diseases Offshore; Diving Operations;
Dropped Objects; Fall into Water; Lifting Equipment; Biological Agents;
Radiation; Breathing Apparatus; Pipelines or Pipeline Works).
RIDDOR 2013
Over-seven-day injuries to workers
4.-(2) Where any person at work is incapacitated for routine work for more than seven
consecutive days (excluding the day of the accident) because of an injury resulting from an
accident arising out of or in connection with that work, the responsible person must send a
report to the relevant enforcing authority in an approved manner as soon as practicable
and in any event within 15 days of the accident.
☐
Occupational diseases
8. Where, in relation to a person at work, the responsible person receives a diagnosis of:
(a) Carpal Tunnel Syndrome, where the person’s work involves regular use of
percussive or vibrating tools;
(b) cramp in the hand or forearm, where the person’s work involves prolonged periods
of repetitive movement of the fingers, hand or arm;
(c) occupational dermatitis, where the person’s work involves significant or regular
exposure to a known skin sensitizer or irritant;
(d) Hand Arm Vibration Syndrome, where the person’s work involves regular use of
percussive or vibrating tools, or the holding of materials which are subject to
percussive processes, or processes causing vibration;
(e) occupational asthma, where the person’s work involves significant or regular
exposure to a known respiratory sensitizer; or
(f) tendonitis or tenosynovitis in the hand or forearm, where the person’s work is
physically demanding and involves frequent, repetitive movements,
☐
the responsible person must follow the reporting procedure, subject to regulations 14 and
15.
Exposure to carcinogens, mutagens and biological agents
9. Where, in relation to a person at work, the responsible person receives a diagnosis of:
(a) any cancer attributed to an occupational exposure to a known human carcinogen
or mutagen (including ionising radiation); or
(b) any disease attributed to an occupational exposure to a biological agent,
☐
the responsible person must follow the reporting procedure, subject to regulations 14 and
15.
Diseases offshore
10. Where, in relation to a person at an offshore workplace, the responsible person
receives a diagnosis of any of the diseases listed in Schedule 3, the responsible person
must follow the reporting procedure, subject to regulations 14 and 15.
Schedule 1 Part 1 2.(1) Where required to follow the reporting procedure by regulation 8
or 10, the responsible person must send a report of the diagnosis in an approved manner
to the relevant enforcing authority without delay.
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☐
☐
Report of an Oil and Gas Incident (ROGI) Form
Diving Operations Schedule 2
13. The failure, damaging or endangering of—
(a) any life support equipment, including control panels, hoses and breathing
apparatus; or
(b) the dive platform, or any failure of the dive platform to remain on station,
which causes a significant risk of personal injury to a diver.
☐
14. The failure or endangering of any lifting equipment associated with a diving operation.
15. The trapping of a diver.
16. Any explosion in the vicinity of a diver.
17. Any uncontrolled ascent or any omitted decompression which causes a significant risk
of personal injury to a diver.
RIDDOR Schedule 2 Part 6
80. - Dropped Objects
The dropping of any object on an offshore installation or on an attendant vessel or into the
water adjacent to an installation or vessel which could cause a specified injury to, or the
death of, any person.
87. - Fall into Water
☐
☐
Any fall of a person into water from more than 2 metres
RIDDOR Schedule 2 Part 1
1. - Lifting equipment
The collapse, overturning or failure of any load-bearing part of any lifting equipment, other
than an accessory for lifting.
☐
10. - Biological agents
Any accident or incident which results or could have resulted in the release or escape of a
biological agent likely to cause severe human infection or illness.
☐
11. - Radiation generators and radiography
(1) The malfunction of— (a)a radiation generator or its ancillary equipment used in fixed or
mobile industrial radiography, the irradiation of food or the processing of products by
irradiation, which causes it to fail to de-energise at the end of the intended exposure
period; or (b)equipment used in fixed or mobile industrial radiography or gamma irradiation,
which causes a radioactive source to fail to return to its safe position by the normal means
at the end of the intended exposure period.
☐
(2) In this paragraph, “radiation generator” means any electrical equipment emitting
ionising radiation and containing components operating at a potential difference of more
than 5kV.
12. - Breathing apparatus
The malfunction of breathing apparatus— (a)where the malfunction causes a significant
risk of personal injury to the user; or (b)during testing immediately prior to use, where the
malfunction would have caused a significant risk to the health and safety of the user had it
occurred during use, other than at a mine.
☐
21. - Pipelines or pipelines works
In relation to a pipeline or pipeline works— (a) any damage to, accidental or uncontrolled
release from or inrush of anything into a pipeline; (b) the failure of any pipeline isolation
device, associated equipment or system; or (c) the failure of equipment involved with
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Report of an Oil and Gas Incident (ROGI) Form
pipeline works, which could cause personal injury to any person, or which results in the
pipeline being shut down for more than 24 hours.
22. - Pipelines or pipelines works
The unintentional change in position of a pipeline, or in the subsoil or seabed in the vicinity,
which requires immediate attention to safeguard the pipeline’s integrity or safety.
☐
Part L Criteria
Death or Loss of a Person Pursuant to MAR Regulation 21B.
(Note: Although provided within the ROGI Form this must be printed and
sent to the Registrar General of Shipping and Seamen)
Offshore Installations and Pipelines works (Management & Administration) Regulations 1995
Notification of death or loss to the Registrar General of Shipping and Seamen as required
☐
Remarks (EU Implementing Regulation Remarks)
If the incident falls into one of the above mentioned categories, the operator/owner shall proceed to the
relevant section(s); hence a single incident could result in completing multiple sections. The operator/owner
shall submit the filled in sections to the Competent Authority within 10 working days of the event, using the
best information available at that time. If the event reported is a major accident, the Member State shall initiate
a thorough investigation in accordance with Article 26 of Directive 2013/30/EU.
Fatalities and serious injuries are reported under the requirements of Directive 92/91/EEC
Helicopter incidents are reported under CAA regulations. If a helicopter accident occurs in relation to Directive
2013/30/EU, section F shall be completed.
Taking into account Member States' obligations to maintain or achieve Good Environmental Status under
Directive 2008/56/EC (3), if an unintended release of oil, gas or other hazardous substance, or the failure of a
safety and environmental critical element results in or is likely to result in degradation of the environment, such
impacts should be reported to the competent authorities.
.
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Report of an Oil and Gas Incident (ROGI) Form
Part A Detailed Report
Unintended Release of Oil, Gas or Hazardous Substance (ignited or not),
Fires and Explosions
Implementing Regulation Section A: Unintended release of oil, gas or other hazardous
substances, whether or not ignited
RIDDOR 2013, Part 6 Dangerous Occurrences which are reportable in respect of an offshore
workplace – 75; Release of Petroleum Hydrocarbon / 76; Fire or explosion / 77; Release or
escape of dangerous substances; Voluntary HCR reporting
Also complete for the unintentional releases from a pipeline within the 500 meter zone of an
installation
Section A1
Was there a release of hydrocarbon substances?
☐
☐
Yes
If Yes complete from A1
No
If No, go to A2
i. Hydrocarbon Released
☐
Non Process
Please specify
(Voluntary)
☐
Process
Choose a Hydrocarbon type
☐
Oil
☐
Gas
☐
Condensate
☐
2-Phase
For gas or 2-Phase, state level of
H2S
Enter estimated ppm. If less than 5 ppm
enter “insignificant”
Enter estimated ppm. If less than 5
ppm enter “insignificant”.
(Voluntary) For gas, estimate
approximate molecular weight
(Voluntary) For 2-Phase, state GOR
(gas/oil ratio)
Specify units.kg/kg, scf/bbl
Enter molecular weight
☐
n/a
Enter GOR and specify units)
☐
n/a
(Voluntary) For liquids, state density
(kg/m3)
Enter density and specify units
(Voluntary) Please state water cut
(where relevant) (%age of liquid by
mass)
Enter water cut
(Voluntary) Was the release
limited/stopped due to a local
ROGI Form 1.1 - Date of Issue 20/07/2015
☐
n/a
☐
Yes
☐
Page 15 of 42
No
Report of an Oil and Gas Incident (ROGI) Form
manual intervention / isolation,
separate from the ESDV system?
(Voluntary) Did liquid spray/mist
releases occur?
ii.
☐
Yes
☐
Estimated quantity released
Estimated quantity released
Enter quantity released and specify units
Specify units e.g. tonnes, kg,
Nm3
[Nm3 is normal cubic metre]
(Voluntary) What is the basis
for this estimate?
Enter description
(Voluntary) Total gas HC
Inventory in system
Enter gas HC Inventory in system and specify units
Specify units e.g. tonnes, kg
Nm3
[Nm3 is normal cubic metre]
(Voluntary) Total liquid HC
Inventory in system
Specify units e.g. tonnes, kg
Enter liquid HC Inventory and specify units
(Voluntary) Extent of dispersion
/ liquid spread
Enter extent of dispersion
(Voluntary) What is the severity
classification of this release
Choose a rating
iii.
Estimated initial release rate
Estimated initial release rate
Enter estimated initial release rate and specify units
Specify units e.g. tonnes/day,
kg/s, Nm3/s
[Nm3/s is normal cubic metre
per second]
(Voluntary) Equivalent hole
diameter
Enter diameter
Based on hole area equated to
a circular hole (mm)
(Voluntary) Is hole size
measured or estimated?
(Voluntary) If estimated, on
what basis?
iv.
☐
Measured
☐
Estimate
Please describe
Duration of leak
Duration of leak
Enter duration and specify units
(seconds/minutes/hours)
(Estimated time from
discovery, e.g. alarm,
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 16 of 42
No
Report of an Oil and Gas Incident (ROGI) Form
electronic log, to termination of
leak)
v.
Location of leak
(Voluntary)
Module / area name
Enter module/area name
(Please state the name in common use on the installation, inluding
subsea if appropriate)
[Please also complete the location check list below. Please indicate
those items which come nearest to pinpointing the location of the leak.]
(Voluntary)
Primary
Select primary category
System Category
Secondary
Select secondary category
Tertiary
Select tertiary category
(Voluntary)
Primary
Select primary category
Equipment category
Secondary
Select secondary category
Tertiary
Select tertiary category
Other
Please specify
(Voluntary)
Valve type
Select one type
(where valve is selected above in equipment category)
Other
Please specify
(Voluntary)
Type
Select one type
Flange type
Rating
Select a rating
(where Flange is selected
above in equipment category)
Bore Size (in)
Enter bore size
Other
Specify Type, Rating and Bore Size
(in)
Please specify
(Voluntary) For valves, flanges, pumps, tubing, pipework, pipelines and
other fittings, please specify their size in terms of nominal bore, in
inches (i.e. the nominal bore of the piping they connect to)
Enter size
(Voluntary) For PIG LAUNCHER/RECEIVERS and PRESSURE
VESSELS give both the LENGTH and the DIAMETER in mm or
inches, as available
Enter size
(Voluntary) For BOP Stacks indicate the design pressure rating, e.g.
5,000 psi.
Enter design pressure rating.
vi.
Hazardous area classification (i.e. zone at location of incident)
☐
Classification
1
☐
☐
2
Unclassified
vii. Module ventilation?
☐
Natural
ROGI Form 1.1 - Date of Issue 20/07/2015
☐
Forced
Page 17 of 42
Report of an Oil and Gas Incident (ROGI) Form
How many sides enclosed?
Enter the number of walls, including floor & ceiling
(Insert the number of walls,
including floor and ceiling)
Module volume (m3)
Enter volume in m3
Estimated number of air changes
(if known)
Specify hourly rate
If “Natural ventilation” is selected
above, type ” n/a”
Specify Hourly rate
viii. Weather conditions
Wind speed
Enter wind speed and specify units
(specify units e.g. mph, m/s, ft/s
or knots)
Wind direction
Enter wind direction
(Specify heading in degrees)
from true north
Provide a description of other
relevant weather conditions
Describe weather conditions
(including sea conditions)
ix.
System pressure
Design Pressure
Enter design pressure and specify units
(Specify units,e.g. bar,psi or
other)
Actual Pressure
Enter actual pressure and specify units
(i.e. at time of release)
(Voluntary) Design Temperature
(maximum)
Enter maximum design temperature and specify units
(Voluntary) Design Temperature
(minimum)
Minimum design temperature and specify units
(Voluntary) Actual Temperature
Actual temperature and specify units
(i.e. at time of release)
x.
Means of detection
Detection systems
☐
Gas
Choose a Gas detection system
☐
Fire
Choose a Fire detection system
☐
Smoke
☐
Other
(Voluntary) Instrumentation of
Process System
Choose an item
(Voluntary) Planned Manual
Choose an item
ROGI Form 1.1 - Date of Issue 20/07/2015
Please specify.
Page 18 of 42
Report of an Oil and Gas Incident (ROGI) Form
Inspection
(Voluntary) Unplanned Manual
Inspection
xi.
Choose an item
Cause of leak
(Voluntary) Please give a short description and complete the checklist below
Describe cause of leak.
☐
Design Failure related to design
☐
Equipment
☐
☐
Internal corrosion
☐
External corrosion
☐
Mechanical failure due to fatigue
☐
Mechanical failure due to wear out
☐
Erosion
☐
Material defect
☐
(Voluntary) Degradation of valve sealing
☐
(Voluntary) Loss of bolt tensioning
☐
(Voluntary) Degradation of flange gasket
☐
(Voluntary) Failure of a temporary repair
☐
(Voluntary) Degredation of permanent or
temporary repair
☐
Other
Please specify
Operation
☐
Incorrectly fitted
☐
Left open
☐
Improper inspection
☐
Improper testing
☐
Improper operation
☐
Improper maintenance
☐
Dropped object
☐
Other impact
☐
Opened when containing HC
☐
(Voluntary) Incorrect fitting of flanges or
bolts during maintenance
☐
(Voluntary) Pressure excursion
☐
(Voluntary) Overflow/over filling
☐
(Voluntary) Break-down of isolation
system during maintenance (technical)
☐
(Voluntary) Work on wrong equipment (not
known to be pressurised)
☐
(Voluntary) Incorrect blinding/isolation
☐
(Voluntary) Maloperation of temporary
hoses
☐
(Voluntary) Maloperation of valve(s)
during manual operation
☐
(Voluntary) Erroneous choice of
installations of sealing device
☐
(Voluntary) Impact from bumping /
collision
☐
(Voluntary) Maloperation of valve(s)
during manual operations
☐
(Voluntary) Valve(s) in incorrect position
after maintenance
☐
(Voluntary) Incorrect installation of small
bore fittings
☐
(Voluntary) Temperature excursion
☐
Other
ROGI Form 1.1 - Date of Issue 20/07/2015
Please specify
Page 19 of 42
Report of an Oil and Gas Incident (ROGI) Form
☐
Procedural
☐
Non-compliance with procedure
☐
Deficient procedure
☐
Other
☐
Non-compliance with permit-to-work
Please specify
Indicate the operational mode in the area at the time of release
Choose the relevant parameter(s) from the following categories
☐
Construction
☐
☐
Hot work
☐
Cold work
☐
Draining
Drilling
☐
☐
(Voluntary) Oil
(Voluntary) Gas
☐
(Voluntary) Exploration
☐
(Voluntary) Exploration
☐
(Voluntary) Appraisal
☐
(Voluntary) Appraisal
☐
(Voluntary) Development
☐
(Voluntary) Development
Maintenance
☐
☐
Hot work
☐
Cold work
☐
Draining
☐
Cold work
☐
Draining
Routine Maintenance
☐
☐
Hot work
☐
Normal Production
☐
Pipeline operations including Pigging
☐
Well Operations with Tree
☐
☐
(Voluntary) Oil
☐
(Voluntary) Gas
☐
(Voluntary) Wireline
☐
(Voluntary) Wireline
☐
(Voluntary) Coiled tubing
☐
(Voluntary) Coiled tubing
☐
(Voluntary) Snubbing
☐
(Voluntary) Snubbing
☐
(Voluntary) Well test
☐
(Voluntary) Well test
☐
(Voluntary) Abandonment
☐
(Voluntary) Abandonment
☐
(Voluntary) Service
☐
(Voluntary) Service
☐
(Voluntary) Construction
☐
(Voluntary) Construction
☐
(Voluntary) Other
☐
(Voluntary) Other
Well Operations without Tree
☐
(Voluntary) Oil
ROGI Form 1.1 - Date of Issue 20/07/2015
☐
(Voluntary) Gas
Page 20 of 42
Report of an Oil and Gas Incident (ROGI) Form
☐
(Voluntary) Wireline
☐
(Voluntary) Wireline
☐
(Voluntary) Coiled tubing
☐
(Voluntary) Coiled tubing
☐
(Voluntary) Snubbing
☐
(Voluntary) Snubbing
☐
(Voluntary) Well test
☐
(Voluntary) Well test
☐
(Voluntary) Abandonment
☐
(Voluntary) Abandonment
☐
(Voluntary) Service
☐
(Voluntary) Service
☐
(Voluntary) Construction
☐
(Voluntary) Construction
☐
(Voluntary) Other
☐
(Voluntary) Other
☐
(Voluntary) Blowdown
☐
(Voluntary) Commissioning
☐
(Voluntary) Cleaning
☐
(Voluntary) Flushing
☐
(Voluntary) Installation
☐
(Voluntary) Inspection
☐
(Voluntary) Reinstatement
☐
(Voluntary) Removal
☐
(Voluntary) Replacement
☐
(Voluntary) Sampling
☐
(Voluntary) Shutdown
☐
(Voluntary) Shutting down
☐
(Voluntary) Start up
☐
(Voluntary) Temporary
☐
(Voluntary) Testings
☐
(Voluntary) Top up
xii. Did ignition occur?
☐
Yes
☐
No
Immediate
☐
Delayed
If yes, was it:
☐
Delay time (sec)
(Voluntary) Was it an ignition of
a continuous operational
release?
☐
Yes
ROGI Form 1.1 - Date of Issue 20/07/2015
Enter time (sec).
☐
No
Page 21 of 42
Report of an Oil and Gas Incident (ROGI) Form
Was there: (add sequence of
events by numbering appropriate
boxes in order of occurrence)
Enter sequence
number
A flash fire
Enter sequence
number
A jet fire
(no blast
damage)
(including spray
fires)
Enter sequence
number
An explosion
Enter sequence
number
A pool fire
(sufficient to cause
blast damage)
xiii. Ignition Source (if known)
Provide a description of the
ignition source
Describe ignition source
xiv. What emergency action was taken?
☐
Shutdown
☐
Automatic ESD initiation
☐
Manual
☐
(Voluntary) ESD initiation
☐
(Voluntary) Local initiation
☐
Blowdown
☐
Automatic
☐
Manual
☐
Deluge
☐
Automatic
☐
Manual
☐
CO2/Halon/inerts
☐
Automatic
☐
Manual
☐
Other
(Voluntary) Time between
detection and isolation.
Please specify
Enter time and specify units
(Specify units, e.g. seconds,
Minutes)
(Voluntary) Time between
detection and start of blowdown.
Enter time and specify units
(Specify units, e.g. seconds,
Minutes)
☐
Call to muster
☐
At stations
☐
At lifeboats
☐
(Voluntary) Partial down
man
☐
By helicopter
☐
By lifeboats
☐
By lifeboats
Other
☐
(Voluntary) Installation
evacuation
☐
Other
Please specify
By helicopter
Please specify
xv. Any additional comments
Enter additional comments
Section A2
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 22 of 42
Report of an Oil and Gas Incident (ROGI) Form
Description of circumstances, consequences of event and emergency response
Enter description
Was there a release of a nonhydrocarbon hazardous
substance?
Was there a non-hydrocarbon
fire (e.g. electrical) with a
significant potential to cause a
major accident?
☐
If yes, specify the type and quantity
of released substance
☐
No
Specify type and units
Enter description
☐
Is the incident likely to cause
degradation to the surrounding
marine environment?
If yes, outline the environmental
impacts which may have already
been observed or are likely to
result from the incident
Yes
Yes
☐
No
Enter outline
Section A3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter causes
Section A4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Enter recommendations and lessons learned
End of Part A Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 23 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part B Detailed Report
Dangerous Occurrence in Relation to a Well
Implementing Regulation : Section B
Loss of Well Control Requiring Actuation of Well Control Equipment, or Failure of a Well
Barrier Requiring its Replacement or Repair.
RIDDOR 2013, Schedule 2 Dangerous Occurrences Part 1 (General) Wells 20. In Relation to
a Well (Other Than a Well Sunk for the Purpose of the Abstraction of Water)
Section B1
General information
Name/code of well
Enter name/code
Name of drilling contractor (if
relevant)
Enter name of drilling contractor
Name/type of drilling rig (if relevant)
Enter name/type of drilling rig
Start date/time of loss of well
control
Enter a start date
Enter a start time hh:mm
End date/time of loss of well control
Enter an end date
Enter an end time hh:mm
Type of fluid (if relevant)
Well head completion
☐
Brine
☐
Other
☐
☐
Surface
Enter depth
Reservoir: pressure / temperature /
depth
Enter pressure/temperature/depth
Type of well services
Gas
Please specify
Water depth (m)
Type of activity
☐
Oil
☐
Subsea
☐
Normal production
☐
Drilling
☐
Work over
☐
Well services
☐
Other
☐
Wire line
☐
Other
Please specify
☐
Coiled tubing
☐
Snubbing
Please specify
Section B2
Description of circumstances, consequences of event and emergency response
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 24 of 42
Report of an Oil and Gas Incident (ROGI) Form
Implementation Regulation B1 & RIDDOR 20.(a)(b)(d)(e)
Blowout prevention equipment
activated
☐
Yes
☐
No
Diverter system in operation
☐
Yes
☐
No
Pressure build-up and/or positive
flow check
☐
Yes
☐
No
Failing well barriers
(a)
Enter text
(b)
Enter text
(c)
Enter text
☐
Yes
☐
No
RIDDOR 20 (c)
Detection of Hydrogen Sulphide
Description of circumstances
Enter Description.
Further details
(specify units)
☐
Duration of uncontrolled flow of well-fluids
Enter further details and specify units
☐
Flowrate
Enter further details and specify units
☐
Liquid volume
Enter further details and specify units
☐
Gas volume
Enter further details and specify units
Consequences of event and emergency response
(e.g. 1. Jet fire / 2. First explosion / 3. Second explosion, etc.)
Enter details
Section B3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter cause
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 25 of 42
Report of an Oil and Gas Incident (ROGI) Form
Section B4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Enter lessons learned and recommendations
End of Part B Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 26 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part C Detailed Report
Failure of a Safety & Environmental Critical Element
Implementing Regulation Section C
Failure of a Safety and Environmental Critical Element
Section C1
General information
Name of independent verifier
Enter name of independent verifier
(if applicable)
Section C2
Description of circumstances, consequences of event and emergency response
Which Safety and Environmental Critical systems were reported by the independent verifier as lost or unavailable,
requiring immediate remedial action, or have failed during an incident?
Description of SECE and circumstances
Which Safety and Environmental Critical systems were reported by the independent verifier as lost or unavailable,
requiring immediate remedial action, or have failed during an incident?
Enter description
☐
Origin
Report Independent verifier
(report nr. / date / verifier / …)
Enter details
☐
Failure during major accident.
(date / accident description / …)
Enter details
Safety and Environmental Critical elements concerned
Structural integrity systems
Process containment systems
☐
Topside structures
☐
☐
Subsea structures
☐
☐
Other
☐
Primary well barrier
☐
Secondary well barrier
☐
Wireline equipment
☐
Mud processing
☐
Sand filters
☐
Pipelines & risers
ROGI Form 1.1 - Date of Issue 20/07/2015
Cranes & lifting equipment
Mooring systems (anchor
line, dynamic positioning)
Please specify
Page 27 of 42
Report of an Oil and Gas Incident (ROGI) Form
Ignition control systems
Detection systems
Process containment relief systems
Protection systems
Shutdown systems
Navigational aids
Rotating equipment – power supply
☐
Piping system
☐
☐
Well control process
equipment - BOP
Other
☐
Hazardous area ventilation
☐
Non-hazardous area
ventilation
☐
ATEX certified equipment
☐
Electrical tripping
equipment
☐
Earthing/bonding
equipment
☐
Inert Gas system
☐
Other
☐
Fire & gas detection
☐
Sand
☐
Other
☐
Well control process
equipment - diverter
☐
Gas tight floors
☐
Other
☐
Deluge
☐
Helideck foam system
☐
Fire water pumps
☐
Firewater system
☐
Passive fire protection
system
☐
Fire / blast walls
☐
CO2 / Halon fire-fighting
system
☐
Other
☐
Local shutdown systems
(LSD)
☐
Process shutdown system
(PSD)
☐
Subsea isolation valve
☐
Emergency shutdown
system (ESD)
☐
Riser ESD valve
☐
Topsides ESD valve
☐
Blowdown
☐
Other
☐
Aircraft navigation aids
☐
Other
☐
Turbine P.M. for
compressor
☐
Other
ROGI Form 1.1 - Date of Issue 20/07/2015
☐
Pressure vessels
Please specify
Please specify
☐
Chemical injection monitor
Please specify
☐
Relief systems
Please specify
Please specify
Please specify
☐
Seacraft navig. aids
Please specify
☐
Turbine P.M. for
generator
Please specify
Page 28 of 42
Report of an Oil and Gas Incident (ROGI) Form
Escape, evacuation and rescue
equipment
Communication systems
Other
☐
Personal safety equipment
☐
Lifeboats / TEMPSC
☐
Tertiary escape means
(lifecraft)
☐
Temporary refuge /
Muster area
☐
Search & rescue facilities
☐
Other
☐
Radios / telephones
☐
Other
☐
Please specify
☐
Yes
Please specify
☐
Public address
Please specify
Description of consequences
Is the incident likely to cause
degradation to the surrounding
marine environment?
☐
No
If yes, outline the environmental impacts which have already been observed
or are likely to result from the incident
Enter outline
Section C3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter causes
Section C4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Describe any important lessons learned from the event. List recommendations to prevent the recurrence of similar
events.
Enter lessons learned and recommendations
End of Part C Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 29 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part D Detailed Report
Danger to the Integrity of an Installation, Collapses, Equipment failure,
Weather Damage, Seabed Subsidence
Implementing Regulation 1112/2014 Section D Significant loss of structural integrity, or loss of
protection against the effects of fire or explosion, or loss of station keeping in relation to a
mobile installation
RIDDOR 2013, Schedule 2 Dangerous Occurrences Part 6
78; Collapses / 79; Equipment; / 81; Weather damage / 84; Subsidence or collapse of seabed
/ 85; Loss of stability or buoyancy
DCR REG 9: Reporting of danger to an installation
Section D1
General information
Name of vessel (if applicable)
Enter name of vessel
Section D2
Description of circumstances, consequences of event and emergency response
Indicate the system that failed and provide a description of the circumstances of the event / describe what has
happened including weather conditions and sea state.
Enter description
Section D3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter causes
Section D4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Enter lessons learned and recommendations
End of Part D Retailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 30 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part E Detailed Report
Vessel Collisions, or Potential Collisions, with an installation
Implementing Regulation Section E : Vessels on Collision Course and Actual Vessel
Collisions with an Offshore Installation
RIDDOR 2013; Schedule 2 Part 6 Dangerous occurrences which are reported in respect of an
offshore workplace
82. & 83 Collisions
Section E1
General information
Name / Flag State of vessel (if
Enter name / flag state of vessel
applicable)
Type / tonnage of vessel (if
Enter type / tonnage of vessel
applicable)
Contact via AIS?
☐
Yes
☐
No
Section E2
Description of circumstances, consequences of event and emergency response
Indicate the system that failed and provide a description of the circumstances of the event / describe what has
happened (minimum distance between vessel and installation, course and speed of vessel, weather condition)
Enter description
Section E3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter causes
Section E4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Enter lessons learned and recommendations
End of Part E Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 31 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part F Detailed Report
Aircraft Collisions, or Potential collisions, with an installation
Implementing Regulation Section F : Helicopter Accidents, on or near Offshore Installations
Helicopter Incidents are Reported under CAA Regulations. If a Helicopter accident occurs in
relation to Directive 2013/30/EU, Section F shall be completed.
RIDDOR SCHEDULE 2 Part 6 82. Collisions
Section F1
General information
Name of helicopter contractor
Enter name of helicopter contractor
Helicopter type
Enter helicopter type
Number of persons on board
Enter number of persons on board
Section F2
Description of circumstances, consequences of event and emergency response
Indicate the system that failed and provide a description of the circumstances of the event / describe what has
happened (weather conditions)
Enter description
Section F3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter causes
Section F4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Enter lessons learned and recommendations
End of Part F Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 32 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part G Detailed Report
Fatalities
Implementing Regulation Section G : Any fatal accident to be reported under the
requirements of Directive 92/91/EEC “The employer shall, without delay report any serious
and/or fatal occupational accidents and situations of serious danger to the competent
authorities”
RIDDOR 2013 6. Work-related fatalities & Schedule 1 Part 1 Injuries, fatalities and dangerous
occurrences/ Schedule 1 Part 1 Injuries, fatalities and dangerous occurrences
☐
Please complete section K
Note : Consider if there is requirement to also complete Section L Form to be Completed in
respect of the death or loss of a person pursuant to Regulation 21B – Offshore Installations
and Pipelines Works (Management and Administration) Regulations 1995
End of Part G Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 33 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part H Detailed Report
Serious Injuries
Implementing Regulation Section H ; Any serious injuries to five or more persons in the same
accident to be reported under the requirements of Directive 92/91/EEC “The employer shall,
without delay report any serious and/or fatal occupational accidents and situations of serious
danger to the competent authorities”
RIDDOR 2013, 4. Non-fatal injuries to workers/ Schedule 1 Part 1 Injuries, fatalities and
dangerous occurrences
☐
Please complete section K
Note: Consider if there is requirement to also complete Section L Form to be Completed in
respect of the death or loss of a person pursuant to Regulation 21B – Offshore Installations
and Pipelines Works (Management and Administration) Regulations 1995
End of Part H Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 34 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part I Detailed Report
Partial or Complete Evacuation of Personnel
Implementing Regulation Section I Any evacuation of personnel.
RIDDOR 2013, dangerous Occurrences, Schedule 2 Part 6- 86. Evacuation
Section I1
General information
Start date and time of evacuation
Enter a date
Enter time hh:mm
End date and time of evacuation
Click here to enter a date
Enter time hh:mm
Section I2
Description of circumstances, consequences of event and emergency response
Indicate the system that failed and provide a description of the circumstances of the event / describe what has
happened (weather conditions)
Was the evacuation
precautionary or emergency?
☐
Precautionary
☐
Emergency
☐
Both
Number of persons evacuated
Enter number of persons evacuated
Means of evacuation (e.g. helicopter)
Enter means of evacuation
Indicate the system that failed and provide a description of the circumstances of the event / describe what has
happened, unless already reported in a previous section of this report.
Enter description
Section I3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter causes
Section I4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Enter lessons learned and recommendations
ROGI Form 1.1 - Date of Issue 20/07/2015
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Report of an Oil and Gas Incident (ROGI) Form
End of Part I detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
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Report of an Oil and Gas Incident (ROGI) Form
Part J Detailed Report
Major environmental Incident arising from a Safety incident. (Note: PON1
reporting is still a requirement. The ROGI form is additional in the event of a
Major environmental incident
Implementing Regulation Section J: A Major Environmental Incident
Section J1
General information
Name of contractor (if applicable)
Enter name of contractor
Section J2
Description of circumstances, consequences of event and emergency response
Indicate the system that failed and provide a description of the circumstances of the event / describe what has
happened. What are or are likely to be the significant adverse effects on the environment?
Enter description
Section J3
Preliminary direct and underlying causes (within 10 working days of the event)
Enter causes
Section J4
Initial lessons learned and preliminary recommendations to prevent recurrence of similar events (within
10 working days of the event)
Enter lessons learned and recommendations
End of Part J Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
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Report of an Oil and Gas Incident (ROGI) Form
Part K Detailed Report
Other reportable injuries, Diseases and Dangerous Occurrences : (Over
Seven day injuries, Occupational Diseases; Exposure to Carcinogens,
Mutagens and Biological Agents: Diseases Offshore; Diving Operations;
Dropped Objects; Fall into Water; Lifting equipment; Biological agents;
Radiation; Breathing Apparatus; Pipelines or Pipeline Works)
RIDDOR 2013 4(2) Over-Seven-Day Injuries to Workers/8. & Schedule 1 Part 1
2.(1)Occupational Diseases/9. Exposure to Carcinogens, Mutagens and Biological Agents/10.
& Schedule 1 Part 1 2.(1) Diseases Offshore/ Diving Operations Schedule 2 13-17
Dangerous Occurrence Form: RIDDOR Schedule 2 Part 6 80. Dropped Objects/ 87. Fall into
Water
Accident Report
About the kind of accident
Select the kind of accident that best describes the
incident
Choose kind of accident
If a fall from height- how high was the fall (to the
nearest meter)
Enter measurement
Work process involved in the incident
Choose a work process
Main factor involved in the incident
Choose a main factor
Describe what happened
(give as much detail as you can, including i) the events that led to the incident ii) the operation or activity in
progress. Describe any action taken to prevent similar incidents occurring.)
Enter description
About the Injured person
Name
Family name
Address Line 1
Enter address line1
Address Line 2
Enter address line 2
Address Line 3
Enter address line 3
Town
Enter Town
County
Enter county
Post Code
Enter postcode
Gender
Age
☐
Male
Phone No
☐
Enter phone number
Female
Enter age
ROGI Form 1.1 - Date of Issue 20/07/2015
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Report of an Oil and Gas Incident (ROGI) Form
Injured person’s employment status
Was the injured person
☐
One of your employees?
☐
On a training scheme?
☐
Employed by someone
else?
☐
On work experience?
☐
Self-employed and at
work?
☐
Member of the public?
☐
No
Details if the person was on a training scheme / employed by someone else
Enter details
About the severity of the person’s injuries
Please refer to the help for guidance on severity of injury
Please help us determine the severity of the injury
Was the injury fatal
☐
Yes
If no, was the worker’s injury one of these (as specified under RIDDOR):








☐
bone fracture excluding finger, thumb or toe
amputation of arm, hand, finger, thumb, leg, foot or toe
blinding or permanent sight reduction
crush injuries leading to brain damage or internal organ damage
serious burns
scalping requiring hospital treatment
loss of consciousness caused by head injury or asphyxia
injuries associated with working in an enclosed space leading to
hypothermia or heat-induced illness, resuscitation, hospitalisation for
over 24 hours
Yes
☐
No
If no, the injury prevented the worker
from carrying out their routine work for
more than 7 days
☐
Yes
The injury was to a member of the
public taken directly to hospital /
injured on hospital premises
☐
Yes
About the person’s injuries
Injuries
Choose an injury
Parts of the body Affected
Choose the part of the body affected
ROGI Form 1.1 - Date of Issue 20/07/2015
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Report of an Oil and Gas Incident (ROGI) Form
Dangerous Occurrence Report
Type of dangerous occurrence
Choose an occurrence
Describe what happened
Enter description
Occupational Disease Report
Affected person’s name
Enter name
☐
Male
☐
Female
Gender
Age
Enter age
What was the person’s occupation or job title
Enter occupation or job title
Work Status
Enter work status
Date the disease was diagnosed / confirmed
Enter date
Where was the disease contracted?
Enter location
Disease category diagnosed
Choose a disease category
Specify the diagnosed disease
Enter disease
Details of the work activity that led to the disease
Enter work related cause
End of Part K Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
Page 40 of 42
Report of an Oil and Gas Incident (ROGI) Form
Part L Detailed Report
Death or Loss of a Person Pursuant to MAR Regulation 21B (Note: although
provided within the ROGI Form this must be printed and sent to the Registrar
General of Shipping and Seamen)
Form to be Completed in respect of the death or loss of a person pursuant to Regulation 21B
– Offshore Installations and Pipelines Works (Management and Administration) Regulations
1995
Section L only is to be printed out and the form is to be sent to the :
Registrar General of Shipping and Seamen
Anchor Court
Keen Road
Cardiff
CF24 5JW
PART 1
Name or other designation of
offshore installation
Enter name of offshore installation
Date of death or loss
Enter date
Place of death or loss(a)
Enter location
Full name of deceased or person
lost(b)
Enter name
Gender
☐
Age
Enter age
Capacity in which person
deceased or lost was engaged or
other reason for presence at the
installation
Enter details
Cause of death or loss(c)
Enter cause
Male
☐
Female
I certify that the particulars entered above are true to the best of my knowledge and belief:
Signature of installation manager
furnishing information
ROGI Form 1.1 - Date of Issue 20/07/2015
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Report of an Oil and Gas Incident (ROGI) Form
Name of installation manager
furnishing information(b)
Enter name
Status of signatory
Enter status
Date of signing
Enter date
PART 2(d)
Date of birth
Enter date in format dd/mm/yyyy
Usual place of residence
Enter location
Nationality of deceased or person
lost
Enter nationality
Name and address of next-of-kin
Enter name
Enter address
Relationship of next-of-kin
Enter relationship
I certify that the particulars entered above are true to the best of my knowledge and belief:
Signature of duty holder
furnishing information or person
acting on behalf of duty holder
Name of duty holder/pm whose
behalf information is furnished
Enter duty holder name
Status of signatory
Enter status
Date of signing
Enter date
NOTES
(a) To be given by geographical co-ordinates.
(b) Forename(s) in full, followed by surname, all in block capitals.
(c) To be accompanied by the certificate of a registered medical practitioner who holds a licence to practise as to
the cause of death or a statement of the reason why such a certificate is not available.
End of Part L Detailed Report
ROGI Form 1.1 - Date of Issue 20/07/2015
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