ACRONYMS AND ABBREVIATIONS ...................................................................................................13
1.0 EXECUTIVE SUMMARY ...........................................................................................................17
1.1 Incident synopsis ........................................................................................................................17
1.2 Scope of Investigation ................................................................................................................17
1.2.1 BP Group and Texas City .................................................................................................18
1.2.2 OSHA ...............................................................................................................................20
1.3 Incident Description ...................................................................................................................21
1.4 Conduct of the Investigation.......................................................................................................22
1.5 Key Technical Findings..............................................................................................................22
1.6 Key Organizational Findings......................................................................................................25
1.7 Recommendations ......................................................................................................................26
1.7.1 New Recommendations....................................................................................................26
1.7.2 Previously Issued Recommendations ...............................................................................27
1.8 Organization of the Report .........................................................................................................29