Forms

These pages provide links to Pipeline Safety related forms.

All PDF forms, unless otherwise indicated, are created using Adobe Acrobat. To view the files you need to have the Adobe Acrobat Reader version 6.0 or higher, available free from Adobe.

- PDF Form available

- fillable PDF Form available

- PDF instructions available

Texas Damage Reporting Form (TDRF) for Excavators

No Damage Non-Compliance Reporting Form

General Pipeline Forms

Form Number	Form Name	PDF Form	Fillable PDF
PS-81	Annual Plastic Pipe Inventory
PS-81	EDI Specifications
PS-82	Plastic Pipeline Installation and/or Removal Report
PS-86A	Texas School Facilities Gas Pipe Testing
PS-86B	Texas School Facilities Gas Pipe Test Results Form
PS-87	Gas & Liquid Transmission Pipeline Proximity to Public Schools
PS-95	Semi-Annual Leak Report
PS-95	EDI Specification
N/A	Integrity Management – Liquid Pipelines Form
N/A	Integrity Management – Natural Gas Form
N/A	Master Meter Evaluation Form
N/A	Hazardous Liquid Evaluation Form
N/A	Gas Transmission Evaluation Form
N/A	Gas Distribution Evaluation Form
N/A	Pipeline Company/Unit/System Data Form

Master Meter Sample Forms

Form Number	Form Name	PDF Form
N/A	Atmospheric Corrosion Control Inspection
N/A	Cathodic Protection Worksheet
N/A	Corrosion Control-Rectifier Inspection
N/A	Gas Distribution Inspection & Leak Repair
N/A	Gas Leak & Repair Report
N/A	Monthly Leak Log
N/A	Monthly Odorization Report
N/A	Patrolling Form
N/A	Patrolling of Pipeline System Form
N/A	Pipeline Test Report
N/A	Regulator Test Report
N/A	Regulator Inspection Report
N/A	Relief Valve Inspection Report
N/A	Sniff Test Form
N/A	Telephonic Report of Customer Leak Report
N/A	Valve Inspection Report
N/A	Valve Location Report

Pipeline Permitting Forms

Form Number	Form Name	PDF Form	Instructions	Fillable PDF	User's Guide	Online Filing
T-4	Gas Operators - Application for permit to Operate a Pipeline in Texas (PS-8000A imbedded in form)				POPS User's Guide	Online filing required
T-4	Liquid Operators - Application for permit to Operate a Pipeline in Texas (PS-8000A imbedded in form)				POPS User's Guide	Online filing required
T-4B	Pipeline Transfer Certification (File with T-4)
	Non-Utility Certificate
	Guidance for Natural Gas Operators/Economic Operators
PS-48	New Construction Report (Updated June 2013)

Pipeline Mapping Forms

Form Number	Form Name	PDF Form
N/A	Pipeline Map Request

Sample Cover Letters
T-4 Submission for New Permits T-4 Submission for Renewal (Overview Map Required, No Digital Mapping Required) T 4 Submission for Permit Amendments and Partial Transfers (to and from) T-4 Submission for Total Transfers where the new operator is keeping the transferred permit active T-4 submission for Total Transfers where the new operator is canceling the permit and adding the lines to one of their existing permits T-4 Submission for Canceling an existing permit
Sample Overview Maps
Sample of map for multiple counties (more than 2) Sample of map for 1-2 counties