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The CSB investigated an explosion at the Motiva Enterprises refinery in Delaware City, DE. The investigation found that the Motiva refinery management systems for mechanical integrity, management of change, and hot work did not adequately prevent and address safety and environmental hazards. Furthermore, the system for investigating "Unsafe Condition" reports at the refinery was inadequate. The investigation also found that corporate management oversight was inadequate. The CSB issued safety recommendations based on these root and contributing causes.
Motiva Enterprises LLC2001-05-I-DE-R8
In light of the findings of this report, conduct periodic audits of storage tank mechanical integrity and design, Unsafe Condition Reports, hot work, management of change, and accountability systems at Motiva oil refineries. Ensure that the audit recommendations are tracked and implemented. Share the findings with the workforce.
Status: Open - Acceptable Response or Alternate Response
2001-05-I-DE-R9
Communicate the findings and recommendations of this report to the workforce and contractors at all Motiva refineries.