The Bureau of Safety and Environmental Enforcement (BSEE) has released its investigation report into a fire at South Marsh Island (SM) 130 A Facility on November 8, 2022. The platform is operated by Talos ERT LLC. The fire broke out while welding was occurring on a dry storage tank on the platform.
The BSEE report documents the JSA that completed, and which should have prevented this fire from occurring:
The JSA identified Energy Isolation and Lockout/Tagout but the lessee failed to lock or tag any valves associated with the ABJ-310 Dry Oil Tank. The ABJ-310 Dry Oil Tank was isolated by closing all inlet valves from the NBK-300 Bulk Oil Treater but failed to lock and tag the valves as per the Talos Lockout / Tagout procedure – 7.3.5 Isolation of Various Systems. Also, as per the Talos Lockout / Tagout procedure, a single closed valve is not an acceptable isolation for potentially hazardous systems in the vicinity of the vessel entry and/or hot work, except when the facility/equipment is shut in and all pressures have been bled to atmospheric pressure. Insertion of blinds/skillets isolating the source is the preferred method. There were no blinds/skillets installed during the welding operation nor was the ABJ310 Dry Oil Tank isolated properly as per the mentioned policy. The ABJ-310 Dry Oil Tank outlet valves were not locked or tagged as per the Talos Lockout / Tagout procedure – 7.3.5 Isolation of Various Systems during welding operations either.
The incident shows the importance of job planning and safety meetings. JSAs are an important resource offshore, documenting hazards associated with each job step, as well as methods to mitigate them. The question posed by this incident, is if the JSA included provisions that could have prevented this fire, why wasn’t it followed? Was the JSA fully discussed and understood by everyone participating in the welding work?
BSEE determined the incident’s probable cause:
Human Performance Error: Not following directions listed in the Hot Work Permit. The Hot Work Permit asked if, combustible and flammable materials have been removed or covered with fire-retardant blankets in good condition and sparks associated with grinding or welding have been evaluated and contained utilizing metal shields, flame resistant guards or shields. The answers are checked off yes. If adequate barriers would have been provided for the thief hatch and the sparks contained, the threat of a fire would have been mitigated to low or no risk.
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