1、Pressure Equipment Integrity Incident InvestigationAPI RECOMMENDED PRACTICE 585 FIRST EDITION, APRIL 2014Special NotesAPI publications necessarily address problems of a general nature. With respect to particular circumstances, local, state, and federal laws and regulations should be reviewed.Neither
2、 API nor any of APIs employees, subcontractors, consultants, committees, or other assignees make any warranty or representation, either express or implied, with respect to the accuracy, completeness, or usefulness of the information contained herein, or assume any liability or responsibility for any
3、 use, or the results of such use, of any information or process disclosed in this publication. Neither API nor any of APIs employees, subcontractors, consultants, or other assignees represent that use of this publication would not infringe upon privately owned rights.Users of this recommended practi
4、ce should not rely exclusively on the information contained in this document. Sound business, scientific, engineering, and safety judgment should be used in employing the information contained herein.Work sites and equipment operations may differ. Users are solely responsible for assessing their spe
5、cific equipment and premises in determining the appropriateness of applying the recommended practice. At all times users should employ sound business, scientific, engineering, and judgment safety when using this recommended practice.API publications may be used by anyone desiring to do so. Every eff
6、ort has been made by the Institute to assure the accuracy and reliability of the data contained in them; however, the Institute makes no representation, warranty, or guarantee in connection with this publication and hereby expressly disclaims any liability or responsibility for loss or damage result
7、ing from its use or for the violation of any authorities having jurisdiction with which this publication may conflict.API publications are published to facilitate the broad availability of proven, sound engineering and operating practices. These publications are not intended to obviate the need for
8、applying sound engineering judgment regarding when and where these publications should be utilized. The formulation and publication of API publications is not intended in any way to inhibit anyone from using any other practices.Any manufacturer marking equipment or materials in conformance with the
9、marking requirements of an API standard is solely responsible for complying with all the applicable requirements of that standard. API does not represent, warrant, or guarantee that such products do in fact conform to the applicable API standard.All rights reserved. No part of this work may be repro
10、duced, translated, stored in a retrieval system, or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. Contact the Publisher, API Publishing Services, 1220 L Street, NW, Washington, DC 20005.Copyright 2014 Ame
11、rican Petroleum InstituteForewordNothing contained in any API publication is to be construed as granting any right, by implication or otherwise, for the manufacture, sale, or use of any method, apparatus, or product covered by letters patent. Neither should anything contained in the publication be c
12、onstrued as insuring anyone against liability for infringement of letters patent.Shall: As used in a standard, “shall” denotes a minimum requirement in order to conform to the specification.Should: As used in a standard, “should” denotes a recommendation or that which is advised but not required in
13、order to conform to the specification.This document was produced under API standardization procedures that ensure appropriate notification and participation in the developmental process and is designated as an API standard. Questions concerning the interpretation of the content of this publication o
14、r comments and questions concerning the procedures under which this publication was developed should be directed in writing to the Director of Standards, American Petroleum Institute, 1220 L Street, NW, Washington, DC 20005. Requests for permission to reproduce or translate all or any part of the ma
15、terial published herein should also be addressed to the director.Generally, API standards are reviewed and revised, reaffirmed, or withdrawn at least every five years. A one-time extension of up to two years may be added to this review cycle. Status of the publication can be ascertained from the API
16、 Standards Department, telephone (202) 682-8000. A catalog of API publications and materials is published annually by API, 1220 L Street, NW, Washington, DC 20005.Suggested revisions are invited and should be submitted to the Standards Department, API, 1220 L Street, NW, Washington, DC 20005, standa
17、rdsapi.org.iiiContentsPage1 Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18、 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 Industry Scope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.3 Flexibility in Application . . . . . . . . . . . . .
19、. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4 Pressure Equipment Integrity (PEI) Focused. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.5 Types of Pressure Equipment Covered . .
20、. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.6 Types of Equipment Excluded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.7 Target Audience. . . . . . . . . .
21、 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.8 Organizational Responsibilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Normative
22、References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Terms, Definitions, Acronyms, and Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.1 Terms
23、and Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.2 Acronyms and Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24、 . . . . 54 PEI Incident Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64.1 PEI Incident Types. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25、 . . . . . . . . . . . . . . . . . . . 64.2 Documenting PEI Incidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 PEI Incident Causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26、 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.1 Types of Causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.2 Determining Causes . . . . . . . . . . . . . . . . . . . . . . . .
27、. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 PEI Incident Investigations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106.1 General . . . . . . . . . . . . . . . . . .
28、. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106.2 PEI Incident Investigation Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106.3 PEI Incident I
29、nvestigation Guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126.4 Initial Response to a PEI Incident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126.5 Type
30、s of Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Conducting PEI Incident Investigations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31、 . . 147.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147.2 Performing Level 1 PEI Incident Investigations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
32、 . . . . . . . . . . . . 147.3 Performing Level 2 PEI Incident Investigations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167.4 Level 3 PEI Incident Investigations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
33、 . . . . . . . . . . . . . 247.5 Component Failure Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258 Training and Qualifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34、. . . . . . . . . . . . . . . . . . . . . 278.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278.2 Incident Investigation Team Leaders . . . . . . . . . . . . . . . . . . . . .
35、. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278.3 Incident Investigation Team Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288.4 Site Management Personnel . . . . . . . . . . . . . . . . . . . . . . . . .
36、. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 Continuous Improvement for PEI Incident Investigations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289.1 Information Sharing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
37、 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289.2 Monitoring of the PEI Incident Investigation Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29vContentsPageAnnex A (informative) Example Reporting Form for PEI Incidents . . . .
38、. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Annex B (informative) Example Application of the “5-Whys” Investigation Methodology . . . . . . . . . . . . . . . . . 31Annex C (informative) Example: Level 1 PEI Incident Investigation Results Form . . . . . . . . . . . . . . . . . .
39、 . . . . . 33Annex D (informative) Example Lists of Generic Evidence to be Gathered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34Annex E (informative) Examples of Questions to Ask Eyewitnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Annex F (informative)
40、Request for Failure Analysis Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Annex G (informative) Example Template for Level 2 or Level 3 PEI Incident Investigation Report . . . . . . . . . 39Bibliography . . . . . . . . . . . . . . . . . . . . . . . . .
41、 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Table1 Example PEI Incident Investigation Guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13vi1Pressure Equipment Integrity Inciden
42、t Investigation1 Scope1.1 GeneralThe purpose of this document is to provide owners/users with practices for developing, implementing, sustaining, and enhancing an investigation program for pressure equipment integrity (PEI) incidents. This recommended practice (RP) describes characteristics of how a
43、n effective investigation could be structured so organizations can learn from PEI incidents. This RP is not intended to define or supplement criteria for compliance with regulatory requirements for which companies already have defined investigation processes in place. Rather, API 585 provides a spec
44、ific focus on investigating PEI failures that are precursors to potential incidents that could have significant impact on safety, health, and environment.Significant mechanical integrity incidents are rarely the result of one isolated issue; there are almost always less severe precursors to a major
45、failure. These precursors are frequently called near misses when they are found. Additionally, this document highlights the value in recognizing these precursor occurrences and promotes investigating them to determine the immediate, contributing, and root causes. If these precursor occurrences are u
46、ncovered, investigated, and the contributing and root causes are resolved, then major catastrophic failures of pressure equipment could be minimized or prevented.1.2 Industry ScopeThe investigation principles and concepts that are presented in this RP are specifically targeted for application to pro
47、cess pressure equipment in the refining and petrochemical industry but could be applied to other equipment at the discretion of the owner/user.1.3 Flexibility in ApplicationBecause of the broad diversity in organizations size, culture, national, and/or local regulatory requirements, API 585 offers u
48、sers the flexibility to apply the investigation methodology within the context of existing incident investigation practices and to accommodate unique local circumstances. API 585 is intended to promote the use of systematic investigations as a way to learn from unexpected leaks and equipment degrada
49、tion or near misses associated with PEI. Investigation methodologies consist of investigators collecting evidence and conducting an analysis of the evidence to determine the causes. Many types of investigation analysis methods exist and are used throughout the industry. This document is not intended to single out one specific analysis method for conducting investigations. This document highlights PEI issues for investigation and provides guidelines and work processes for PEI incident investigations. 1.4 Pressure Equipment Integrity (PEI) FocusedInvestigation is a vital element for learni
