The Commonwealth of Massachusetts

——
DEPARTMENT OF PUBLIC UTILITIES

PIPELINE SAFETY DIVISION

INCIDENT REPORT

Merrimack Valley, Massachusetts

Incident date: September 13, 2018

Final Report date: August 31, 2022

 PIPELINE SAFETY DIVISION

Location:
Merrimack Valley (Lawrence, Andover, North Andover) Massachusetts

Date:
September 13, 2018

Company:
Bay State Gas Company d/b/a Columbia Gas of Massachusetts

Estimated Property Damage:

131 Structures

Injuries:
One civilian fatality, 22 civilian individuals hospitalized for injuries, and an additional seven
firefighters incurred minor injuries.

Report Issued: August 31, 2022

Table of Contents
I. INTRODUCTION .................................................................................. 1
A. Scope of the Investigation ....................................................................... 1
B. Exhibit List ........................................................................................ 2
C. Definitions ......................................................................................... 3
D. Key Acronyms .................................................................................... 5
II. Executive Summary ................................................................................ 7
III. BACKGROUND.................................................................................... 9
A. Columbia Gas of Massachusetts and NiSource .............................................. 9
B. Feeney Brothers................................................................................... 9
C. Regulator Station Construction ................................................................. 9
IV. INVESTIGATION ................................................................................ 10
A. Department’s Initial Response ................................................................. 10
B. National Transportation Safety Board Investigation ....................................... 13
V. RESTORATION ................................................................................... 14
A. Mutual Aid........................................................................................ 14
B. Purging Operations .............................................................................. 15
C. Construction ...................................................................................... 15
VI. PIPELINE SAFETY DIVISION’S INVESTIGATIONS ................................... 17
A. Sensing Line Investigation and Mapping Project .......................................... 17
B. OPP Installation Project ........................................................................ 18
C. MV SLA Project/ South Broadway Incident................................................ 18
D. Dynamic Risk Assessment ..................................................................... 20
E. API-1173 and Professional Engineer Regulations ......................................... 21
VII. DEPARTMENT PROCEEDINGS ............................................................. 22
A. D.P.U. 19-140 and D.P.U. 19-141 .......................................................... 22
B. Acquisition of CMA Assets.................................................................... 25
VIII. Conclusion .......................................................................................... 26
I. INTRODUCTION

A. Scope of the Investigation

The Massachusetts Department of Public Utilities (“Department”), Pipeline Safety

Division (“Division”), pursuant to G.L. c. 164, § 105A and a Federal Certification

Agreement as provided for in 49 U.S.C. § 60105, has investigated an over-pressurization of

distribution piping and components that occurred on September 13, 2018 (“Incident”).

Pursuant to 49 U.S.C. § 60105(c), and as part of the Department’s annual

certification process by the United States Department of Transportation (“U.S. DOT”), the

Department must report to the U.S. DOT:

each accident or incident . . . involving a fatality, personal injury requiring

hospitalization, or property damage or loss of more than an amount the [U.S.
DOT] Secretary establishes, any other accident the [Department] considers
significant, and a summary of the investigation by the [Department] of the
cause and circumstances surrounding the accident or incident.

The Department has established procedures for determining the nature and extent of

violations of codes and regulations pertaining to the safety of pipeline facilities and the

transportation of gas including, but not limited to, G.L. c. 164, §§ 76, 76C, and 105A and

220 CMR §§ 69.00 and 101.00 through 115.00. The Division, on behalf of the Department,

also enforces the U.S. DOT safety standards for gas pipeline systems as set forth in 49 CFR

Parts 40, 192, 193, and 199.

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 B. Exhibit List

Exhibit 1: NTSB Accident Report (NTSB/PAR-19/02)

Exhibit 2: Merrimack Valley Natural Gas Explosions After Action Report

Exhibit 3: CMA Response Attachment IR-PL-1-20(a) (Event Timeline)

Exhibit 4: Columbia Gas Telephonic Incident Notification to Department of Public

Utilities

Exhibit 5: CMA Response Attachment IR-PL-1-11 (Critical Valve Location)

Exhibit 6: CMA Response Attachment IR-PL-1-9 (Regulator Stations around South Union
St Project)

Exhibit 7: Regulator Station and Tie-in location Map

Exhibit 8: Department Letter, January 31, 2020

Exhibit 9: Department Letter, July 7, 2021

Exhibit 10: Boston Globe article on CRO

Exhibit 11: Emergency Management Assistance Compact

Exhibit 12: Restoration Map

Exhibit 13: 19-PL-19 Exit Letter

Exhibit 14: 19-PL-18 Exit Letter

Exhibit 15: 19-PL-24 Leak Exit Letter

Exhibit 16: 19-PL-23 Exit Letter

Exhibit 17a: Dynamic Risk Report Phase 2

Exhibit 17b: Dynamic Risk Report Phase 1

Exhibit 18: 19-PL-07 Exit Letter

Exhibit 19: CMA Initial Jurisdictional Findings Tracker

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Exhibit 20: CMA Leak Report 12.21.22 Filing

C. Definitions

Abandoned Pipeline - An abandoned pipeline is one that is no longer being used by any
pipeline operating company to transport natural gas or oil. Abandoned pipelines are usually
left in the ground but are no longer used or maintained in a usable condition. An
abandoned pipeline is a pipeline that has been physically separated from its source
of gas or hazardous liquid and is no longer maintained under federal regulations. Abandoned
pipelines are usually purged of the gas or liquid they transported and refilled with nitrogen,
water, or a non-flammable slurry mixture.

Covered Task – As defined in 49 CFR 192.801.

Exit Letters – Pursuant to 49 USC § 60108(e)(2), within 90 days, to the extent practicable,
after the completion of a PHMSA pipeline safety inspection, the certified State authority must
provide the owner or operator of gas or hazardous liquid pipeline facility with written
preliminary findings of the inspection.

Incident - As used in pipeline safety regulations, an incident is an event occurring on a

natural gas pipeline for which the operator must make a report to the Office of Pipeline
Safety. Events of similar magnitude affecting hazardous liquid pipelines are
considered accidents. (Reference 49 CFR 191.3, 49 CFR 195.50).

Incident Command System “ICS” - In widespread or major emergencies that could affect
large populations or have significant environmental impacts an ICS is usually established to
coordinate the combined actions of various emergency response personnel. Such emergencies
could include natural disasters, such as tornados, train wrecks involving hazardous materials
or major oil or natural gas pipeline releases. An ICS is an emergency management system
that allows coordination and key decisions to be made by a unified command group
consisting of representatives of involved government (Federal, state, and local), emergency
response organizations (fire, police, medical, hazardous materials) and other responsible
organizations such as, in pipeline related events, the pipeline operator.

Leak Survey - A leak survey is a systematic inspection for the purpose of finding leaks on
a pipeline. The frequency and methods of performing leak surveys are regulated and may
vary depending on several factors.

Low-Pressure Distribution System - A low-pressure distribution system is a pipeline

system designed and used for distributing natural gas, and is characterized by the
gas pressure in the main being substantially the same as the pressure provided to the
consumer.

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Main - A main is a natural gas distribution line that serves as a common source of supply for
more than one service line.

Maximum Allowable Operating Pressure “MAOP” - Maximum allowable operating

pressure is the maximum internal pressure at which a natural gas pipeline or pipeline segment
may be operated.

Meters and Regulating Stations - Metering and regulating stations are installations
containing equipment to measure the amount of gas entering or leaving a pipeline system and,
sometimes, to regulate gas pressure.

New Construction - New construction is the act of building a pipeline facility or expanding
an existing pipeline facility (as in looping a pipeline segment, which may also be done to
meet increased load requirements or to enhance reliability of the system) in order to provide
new service to a customer(s) or in order to meet increased demand.

Pressure Relief Valve - A pressure relief valve is a mechanical safety device that provides
protection to a pressurized container, such as a pipeline, by reducing the internal pressure by
releasing it outside the container.

Purge - The act of freeing a gas conduit of air or a mixture of gas and air.

Regulator - A device used to control the pressure of the pipeline system to which it is
connected.

Regulator Station - Equipment installed for the purpose of automatically reducing and
regulating the gas pressure in the downstream pipeline, main, holder, pressure vessel or
compressor station piping to which it is connected. Included are piping and auxiliary devices
such as valves, control instruments, control lines, the enclosure, and ventilation equipment.
(see pressure regulating station).

Remote Control Valve – A remote control valve is a type of valve that can be operated from
a location other than at the valve site.

Root Cause – Root cause is the basic, underlying causal factor in an incident, accident or
other event scenario which if removed would have prevented the incident, accident or event
from occurring.

Operator Qualification “OQ” Rule – Minimum requirements for operator qualification of

individuals performing covered tasks on a pipeline facility as defined in 49 CFR 192 subpart
N.

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Qualified Individual – A person who has been evaluated and deemed able to; (1) perform
assigned covered tasks; and (2) recognize and react to abnormal operating conditions, and (3)
maintains current qualification.

Over-pressurization – Whenever pressure in a section of pipeline exceeds MAOP.

Tie-in – The connection of one section of pipeline to another. Tie-ins typically occur when
one or both sections are gassed.

D. Key Acronyms

AOC – Abnormal Operating Conditions

API – American Petroleum Institute

CFR - Code of Federal Regulations

CMA - Columbia Gas of Massachusetts

DPU - Massachusetts Department of Public Utilities

EOC - Emergency Operations Center

ERP - Emergency Response Plans

EST – Eastern Standard Time

FMEA - Failure Modes and Effects Analysis

FOL - Field Operations Leader

GIS - Geographic Information System

IC - Incident Commander

ICC – Incident Command Center

ICS – Incident Command System

LFE - Leader of Field Engineering

M&R - Measurement and Regulation

MAOP - Maximum Allowable Operating Pressure

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MEMA - Massachusetts Emergency Management Agency

MOC - Management of Change

NTSB - National Transportation Safety Board

OQ - Operator Qualification

P.E. - Professional Engineer

PHMSA - Pipeline and Hazardous Materials Safety Administration

psi - Pounds Per Square Inch

psig - Pounds Per Square Inch, Gauge

PSMS - Pipeline Safety Management Systems

RP - Recommended Practice

SCADA - Supervisory Control and Data Acquisition system

SMS – Safety Management systems

w.c. - Water Column

WMS - Work Management System

CRO – Chief Recovery Officer

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II. EXECUTIVE SUMMARY

Around 4:00 p.m. EST on September 13, 2018, the low-pressure natural gas

distribution system servicing the Merrimack Valley of Massachusetts was over-pressurized,

resulting in multiple structural fires, explosions, one fatality, and 22 hospitalizations for

injuries, including emergency response personnel. A total of 131 residential and commercial

structures were destroyed across Andover, North Andover, and Lawrence due to the natural

gas induced fires and explosions (Exh. 1, Abstract; Exh. 18, at 1). Columbia Gas of

Massachusetts (“CMA”) owned and operated the distribution system involved in this

Incident.

The Department was notified at 4:50 p.m. via the Division’s Telephonic Incident

Notification system (“TIN”) (Exh. 4). Emergency response was conducted by CMA, police,

and fire departments from Andover, North Andover, and Lawrence. Additional support was

provided by the State Fire Marshall’s Office, the Massachusetts Emergency Management

Agency (“MEMA”), Massachusetts State Police, National Grid Electric, and mutual aid from

neighboring cities, as well as New Hampshire and Maine.

During the three-month restoration period, individuals were without heat, hot water,

and other amenities fueled by natural gas. As a result, MEMA, the American Red Cross,

state and local officials provided alternative housing and other resources to those in need.

Approximately 2,300 families were relocated to alternative housing (Exh. 1, at 13).

The National Transportation Safety Board (“NTSB”) led an investigation into the root

cause of the Incident. The Department supported the investigation and adopted the findings

of NTSB. During the subsequent restoration period, the Department, with mutual aid from

New Hampshire, Maine, and federal authorities, oversaw CMA’s purging and construction

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efforts. The Division issued several Exit Letters to address regulatory compliance with

regulator stations, overpressure protection, and service line abandonment projects.

During its initial investigation and prior to restoration efforts, NTSB determined that

the over-pressurization occurred during the tie-in of a low pressure main (Exh 18, at 1).

CMA failed to account for and relocate the sensing lines from the pipeline to be abandoned

to the pipeline being placed into service. As a result, high-pressure was introduced into the

low-pressure distribution system downstream of the South Union St. at Winthrop Ave.

Regulator Station. In addition, CMA personnel monitoring the distribution system pressure,

failed to have adequate qualifications to identify an AOC for the start-up of the new pipeline

in violation (Exh. 18, at 2).

After NTSB released the final report, the Department opened two proceedings related

the Incident. As part of these proceedings, the Department approved the sale of CMA to

NSTAR Gas Company d/b/a Eversource Energy (“Eversource”). Eversource is a natural gas

distribution company with about 204,947 services operating in Massachusetts. The

Department also approved a settlement agreement where, in addition to selling its assets to

Eversource, CMA was ordered to pay a $56 million payment in lieu of penalties. Part of the

payment funded the establishment of an “Energy Relief Fund” to directly benefit residents of

the Merrimack Valley who were affected by the Incident.

As a result of the Incident, the Department made several internal changes to ensure

increased regulatory and safety oversight of natural gas operators. In addition to hiring a

new Director, the Division hired fifteen new Public Utility Engineers (“PUEs”) to expand the

volume and scope of its inspections of natural gas operators. Through increased inspections,

the Department is able to correct and enforce any observed areas of noncompliance with state

8
and federal pipeline safety laws. Additionally, the Department enacted new regulations

requiring a Professional Engineer (“PE”) stamp on all complex projects undertaken by

natural gas operators.

III. BACKGROUND

A. Columbia Gas of Massachusetts and NiSource

NiSource is an Indiana based energy company with six subsidiary companies across

six different states. CMA is one of NiSource’s subsidiary distribution companies. At the

time of the incident, CMA delivered natural gas to approximately 325,000 customers

including those affected by the events of September 13, 2018 (Exh. 1, at 3-4).

B. Feeney Brothers

Feeney Brothers Utility Services (“Feeney Brothers”) is a utility services company

contracted by CMA for its natural gas distribution system construction needs. Feeney

Brothers was founded in 1988 and operates throughout Massachusetts, Connecticut, and New

York. On September 13, 2018, Feeney Brothers was performing work for CMA on the cast

iron main replacement project in Lawrence. Four Feeney Brothers employees performed the

tie-in at Salem St. and South Union St. in Lawrence the day of the Incident (Exh. 1, at 4).

C. Regulator Station Construction

Both low-pressure and high-pressure natural gas distribution systems are used to

supply natural gas to customers. In a low-pressure natural gas distribution system, the

natural gas in the distribution piping is approximately the same pressure as the pressure

provided to the customer’s piping and used by appliances. Natural gas is typically supplied

to the distribution system from a high-pressure source through a regulator station that reduces

the pressure (Exh. 1 at 4).

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 Merrimack Valley had a low-pressure distribution system that was fed from 14

regulator stations across Lawrence, Andover, and North Andover. Each of these stations

converts an inlet pressure of approximately 90 psig down to approximately 0.5 psig

(12” w.c.) outlet pressure. These stations were the primary means of pressure reduction on

the date of the Incident. The regulator station at Winthrop Ave. and South Union St. in

Lawrence was the location directly affected from the tie-in on September 13, 2018. The

station was equipped with two 3” Grove 900 TE regulators. The monitor regulator was set

to 14” w.c. and the control regulator was set to 11” w.c. The station is equipped with a

critical valve that stops high pressure flow to the station in the case of emergency. This

valve was activated as part of the emergency response (Exh. 1, at 4).

IV. INVESTIGATION

A. Department’s Initial Response

The Division was notified by Columbia Gas of Massachusetts at 4:50 p.m. via the

Division’s TIN system (Exh. 4). The Division Director and three PUEs arrived at CMA’s

Incident Command Center at 55 Marston St. in Lawrence at 9:15 p.m. on September 13,

2018 to assist in emergency response and conduct an initial investigation.

Upon their arrival, Division staff met with members of CMA’s engineering and

compliance departments along with the incident commander to identify the root cause of the

Incident and to confirm shut down of the impacted system. The South Lawrence low

pressure distribution system was affected by the over pressurization event, which included the

city of Lawrence and towns of Andover and North Andover. As part of its emergency

response efforts, at 7:24 p.m., CMA had reported closure of critical valves to regulator

stations supplying the impacted system. After closing the critical valves, CMA believed that

10
the impacted portion of the South Lawrence distribution system had been completely isolated

(Exh. 3, Att. IR-PL-1-20 (a) at 7). However, according to a CMA event timeline, at 10:18

p.m, a ½” w.c. was read at 234 Mount Vernon St. in Lawrence, indicating that gas was

present, and that the system had not been isolated (Exh. 3, Att. IR-PL-1-20 (a) at 8). CMA

then conducted additional readings to determine if gas was present at other locations within

the isolated system. At 2:56 a.m. on September 14, 2018, CMA conducted a purge of the

system (Exh. 3, Att. IR-PL-1-20 (a) at 9). At 4:21 a.m., after completing a purge, CMA

determined that gas was still present and additional actions were required to ensure that it had

achieved positive shutdown and that the system had been completely isolated. CMA

attempted to perform a lock in on 14 regulator stations on the South Lawrence distribution

system. The purpose of the lock in was to isolate the system from any supply of gas by

ensuring that the inlet and outlet valves were completely closed (Exh. 1, at 12). Ten of the

regulator stations were successfully isolated. CMA was unable to confirm that the remaining

four regulator stations were completely isolated. CMA discovered that a critical valve at the

Massachusetts Ave. regulator station was partially open which was the main cause of the

remaining gas in the system. CMA closed the critical valve at this location at 6:26 a.m. on

September 14, 2018. At 6:27 a.m., CMA confirmed positive system shutoff, indicating the

system had been isolated and no gas remained in the system (Exh. 3, Att. IR-PL-1-20 (a) at

9; Exh. 5; Exh. 6).

At 7:00 a.m. on September 14, 2018, a fourth PUE arrived at the Operations

Command Center to relieve one PUE and establish an around the clock rotation. The

Incident Command Center had been moved to a remote location at Winthrop Ave., Lawrence

during the night. The Division Director was stationed at the Incident Command Center.

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One PUE went to all 14 district regulator stations including the regulator station at Winthrop

Ave. at South Union St, Lawrence. The remaining two PUEs oversaw the leak survey

efforts that were being conducted on the affected system throughout the initial investigation.

On a number of occasions during the initial response, there was miscommunication,

difficulty in obtaining information, and slow response due to lack of follow-up between the

Department and CMA. These issues occurred, at least in part, because the Department had

to communicate with several individuals from CMA to obtain accurate information. Once

CMA assigned a dedicated liaison to the Department, the above-mentioned issues were

resolved to ensure the Department could properly oversee the investigation and subsequent

restoration (Exh. 18, at 1).

When CMA was unable to produce an effective action plan for short-term remediation

to the Department, Governor Baker issued a Declaration of Emergency authorizing the

Chairman of the Department to take action under G.L. c. 25 § 4B. This statute allows the

Chairman to take action “necessary to assure public safety and welfare through the priority

restoration or continuing availability of gas, electric, and water utility services.” Under this

authorization, and in response to the lack of resource coordination and effective

communication, the Department directed Eversource 1 to take management control over the

effort to safely restore utility services in the impacted area (Exh. 2, at 45).

1
At the time of the incident, National Grid, the largest operator of gas mains and
services in the Commonwealth, and their union labor force were engaged in a labor
dispute, which limited National Grid’s resources.

12
 B. National Transportation Safety Board Investigation

On September 14, 2018, NTSB arrived and assumed the lead role in the investigation

of the Incident. The Department supported NTSB’s investigation through interviews,

inspections, and data gathering. NTSB departed the Merrimack Valley after its investigation

had been conducted and prior to restoration preparations being made. Through its

investigation, NTSB concluded that the root cause of the over-pressurization of the

low-pressure natural gas system was CMA’s failure to adequately plan, design, review, and

manage a construction project that resulted in the existing regulator station sensing lines

being left connected to newly abandoned cast iron main (Exh. 1, at vii). Without relocating

the sensing lines to the newly installed main, the regulator station at Winthrop Ave. and

South Union St. in Lawrence received readings from the abandoned cast iron main and

functioned, as designed, by introducing additional pressure into the low-pressure distribution

system (Exh. 1, at 48; Exh. 7). A “false” reading of no pressure resulted in the regulators

at this station over-pressurizing the downstream low-pressure distribution system. NTSB

found that low-pressure natural gas distribution systems that use only sensing lines and

regulators as the means to detect and prevent over-pressurization are not sufficient to prevent

over-pressurization (Exh. 1, at 48). A comprehensive and formal risk assessment, such as a

failure modes and effects analysis, would have identified the human error that caused the

redundant regulators to open and overpressurize the system. (Exh. 1, at 48).

NTSB noted that at the time of the incident, two PE-licensed CMA employees were

involved with the South Union St. project (Exh. 1, at 29). While they were required to

review the projects, there was no requirement that employees review and sign off on projects

and none of the projects had PE stamps (Exh. 1, at 29). NTSB determined that CMA did

13
not have a sufficient constructability review process that would have detected the work order

to relocate the sensing lines (Exh. 1, at 48). NTSB concluded that requiring a PE stamp

“would illustrate that the plans had been approved by an accredited professional with the

requisite skills, knowledge, and experience to provide a comprehensive review” (Exh. 1, at

48).

The complete investigation and findings of the NTSB report were published on

October 24, 2019. While NTSB conducted its investigation into the root cause of the

incident, the Department focused its oversight on restoration efforts on the impacted system

in Merrimack Valley.

V. RESTORATION

A. Mutual Aid

At 2:52 a.m. on September 14, 2018, CMA requested mutual assistance from

Northeast Gas Association (“NGA”) to assist in the restoration efforts. NGA is a

representative body for natural gas operators across nine states. A total of 27 companies

responded with approximately 650 individuals arriving on site (Exh. 1, at 12). At the

direction of the Department’s Chairman, Eversource took the lead in the restoration process

for the affected towns of the Merrimack Valley. On September 21, 2018, Governor Baker

appointed Joe Albanese, a retired Navy captain, as Chief Recovery Officer (“CRO”) to

oversee additional construction efforts (Exh. 10).

The Department filed an Emergency Management Assistance Compact (“EMAC”)

resource request for mutual aid during the restoration phase. The request was for eight

out-of-state gas pipeline inspectors per week starting October 7, 2018 and ending on

November 24, 2018 (Exh. 11, at 1). Prior to this request, inspectors from New Hampshire,

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Connecticut, Pennsylvania, New York, and PHMSA assisted Division inspectors with

overseeing restoration operations. Throughout the course of the restoration, MEMA

coordinated mutual aid from a total of 38 state pipeline inspectors across ten different states.

PHMSA also provided seven inspectors who contributed to the regulatory oversight during

restoration operations (Exh. 2, at 10). Upon arrival, each out-of-state inspector was given a

copy of CMA’s procedures, a copy of state regulations, and an inspection form to adequately

document findings and provide reporting consistency across all inspections.

B. Purging Operations

Due to the over-pressurization, the integrity of the affected system was compromised.

As a result, new pipe was installed and the affected system was abandoned. To ensure the

affected distribution system was clear of gas, purging operations were conducted prior to the

pipeline’s abandonment. With oversight from the Division, CMA established a purging plan

breaking the affected system into eight zones and furthermore into subsections for a more

efficient purge (Exh. 12). To do so, the main was cut and capped in calculated locations to

separate subsystems. CMA introduced compressed air from venturi air movers at specific

locations to purge gas out of the pipeline at grounded vent stack locations. Calibrated

combustible gas indicator (“CGI”) machines were used at the vent stack locations to ensure a

0% gas reading. Purging operations began on September 21, 2018 and the last zone was

completed on October 3, 2018.

C. Construction

Construction crews throughout the country assisted in the restoration efforts in the

Merrimack Valley. They were trained on CMA procedures and had verified operator

qualifications. Following the purge of each zone, the Division oversaw the abandonment of

15
the affected distribution system and installation of the new main and services. The existing

low-pressure system was upgraded to a high-pressure system. Since much of the old system

was cast iron pipe, it was updated to High Density Poly Ethelene (“HDPE”) plastic. Tie-in

operations were conducted following the construction requirements of each subsection. This

process helped in getting customer’s gas restored as quickly as possible. Construction efforts

were finished on December 16, 2018 (Exh. 2, at 64-67). Meters that were located inside

buildings were moved outside and were equipped with service regulators and excess flow

valves (“EFV”) to support the newly installed high pressure system. Relocating the meters

outside makes shut off valves more accessible to technicians during emergencies, prevents

customer tampering, and provides easier access for safety inspections.

The Division continued its oversight of CMA to ensure compliance with state and

federal regulations after the restoration was complete. Throughout the restoration process

both state and federal regulators and CMA Quality Assurance/Quality Control (“QA/QC”)

personnel identified and documented any non-compliance items and Abnormal Operating

Conditions (“AOCs”). These items consisted primarily of meter/regulator locations, bollard

protection, and EFV identification, and did not warrant immediate remediation.

As of November 12, 2018, the Division identified 1,127 non-compliant items

(Exh. 19). The restoration efforts were nearly complete on December 26, 2018 when 7,083

out of 7,113 affected services had been relit (Exh. 19). Following the completion of

restoration efforts, CMA continued to address the outstanding compliance items and

monitored the newly installed high pressure system for leaks. On December 21, 2018, the

Department received the first leak report from CMA where they identified 45 leaks on the

newly installed piping (Exh. 20). In July 2019, CMA had a total of 22 items remaining on

16
the non-compliance list and 42 of the 45 identified leaks had been remediated (Exh. 20).

Under Division supervision, all AOCs, leaks, and non-compliant items for the restoration

process were resolved by December 19, 2019.

VI. PIPELINE SAFETY DIVISION’S INVESTIGATIONS

A. Sensing Line Investigation and Mapping Project

Following the events on September 13, 2018, the regulator stations of the South

Lawrence distribution system were taken out of service as the system was upgraded to

high-pressure piping during the restoration phase. From February 19, 2019 through April

17, 2019, the Division inspected of CMA’s Regulator Station Control Line Mapping and

Investigation Project for the North Lawrence distribution system (“North Lawrence Project”).

This system was not affected by the events of September 13, 2018, however, the regulator

stations for this system were similar to those found on the affected system. The North

Lawrence Project included the following: validation of station drawings and confirmation of

all components; point-to-point verification of all sensing lines; and verification that

installation conforms with current design practices and addition of control lines for future

use.

On August 15, 2019, the Division issued an Exit Letter with its findings from the

North Lawrence Project (Exh. 13). The inspections included the review of the standard

operating procedures (“SOP”), existing maps and records, operator qualification records,

welding activity, control lines and associated piping, and backfilling operations (Exh. 13, at

1). The Division found several violations of federal and state regulations, including CMA’s

failure to follow its own procedures, failure to follow proper corrosion inspections, and

failure to comply with damage prevention laws (Exh. 13, at 8). The Department found

17
CMA’s actions were in violation of 49 C.F.R. Part 192, (“Part 192”) §§ 192.13(c);

192.457(b); 192.459; 192.605(a); 192.605(b)(3); 192.614(c)(5); and 220 CMR 99.06(3).

B. OPP Installation Project

Following the Project, CMA began an Over-pressure Protection Project for all low-

pressure distribution system regulators. As part of this project, over-pressure protection

devices or “slam shuts” were incorporated in all regulator stations as an additional layer of

over-pressure protection. The Division conducted inspections at the North Lawrence

distribution system regulator stations from May 10, 2019 through July 24, 2019. The over-

pressure protection devices that were installed at these locations were the Pietro-Fiorentini PF

FE 25 regulators with slam-shuts incorporated.

On August 7, 2019, the Division issued an Exit Letter with its findings from this

inspection (Exh. 14). The inspection included the review of the SOPs, existing maps and

records, operator qualification records, welding activity, and regulators and associated

piping. The Division found that CMA had failed to update and follow its own procedures in

violation of Part 192, §§ 192.605(a); 192.727(a)(b) and (d); and 220 C.M.R. § 107.04

(Exh. 14, at 2).

C. MV SLA Project/ South Broadway Incident

On September 11, 2019, CMA met with the Department to disclose issues pertaining

to two abandoned service lines, one of which occurred during the restoration phase of the

Merrimack Valley incident. CMA did not abandon these service lines in the manner required

by federal regulations, state regulations, and CMA’s procedures. As a result, CMA launched

a service line abandonment project (“MV SLA”) to verify service lines abandoned during the

restoration phase of the Merrimack Valley incident were in compliance with federal

18
regulations, state regulations, and CMA procedures. The MV SLA project commenced on

September 19, 2019 and on-site project overview briefings were conducted with PUEs and

the Division Director.

On September 27, 2019, the Division received a TIN from CMA alerting the Division

to a Grade 1 gas leak on a plastic main that CMA installed during the restoration efforts after

the Incident (Exh. 15, at 1). The Division reported to the scene of the incident on South

Broadway in Lawrence with several PUEs on September 27th, 28th, and 29th. The Division

provided oversite while CMA performed emergency response and restoration tasks. A 2”

high pressure plastic main was inserted through an abandoned 6” low pressure main after the

September 13, 2018 incident. On September 27, 2019, a contractor for the municipal water

department exercised, or manipulated, a valve on the abandoned main, causing a Grade 1 gas

leak. The valve was able to be exercised because CMA did not abandon the main as

required by company procedures.

On October 1, 2019, the Division issued a separate Exit Letter documenting its

findings (Exh.15, at 2). The Division found CMA failed to follow procedures abandoning

the valve box in violation of Part 192, § 192.605. The Division continued to oversee CMA’s

MV SLA project.

CMA completed the MV SLA project on November 25, 2019. In total 4,892 services

were verified for abandonment compliance across Andover, North Andover, and Lawrence.

Of these services, CMA disclosed that approximately 921 services needed mitigation. The

Division conducted a sampling of inspections throughout the entire project verifying that

procedures were followed during the verification and mitigation work (Exh. 16, at 1-2).

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 D. Dynamic Risk Assessment

In November 2018, the Department contracted with Dynamic Risk Assessment

Systems, Inc. (“Dynamic Risk”) to conduct an assessment of the Commonwealth’s natural

gas distribution system. The purpose was to evaluate the safety of the system across all

Massachusetts operators, governing bodies, and other stakeholders. Dynamic Risk’s

evaluation was broken down into two Phases. The Phase 1 report, “Massachusetts Gas

Pipeline Safety Assessment” was issued on May 13, 2019. The Phase 2 report, “CMA MV

Restoration Program Assessment” was issued June 22, 2020. Final recommendations were

given for CMA, successor of interest, and the Pipeline Safety Division (Exh. 17a, at 53).

As a result of the Dynamic Risk report, and through legislative funding, the

Department was able to increase its Division staffing, including additional inspectors to

provide essential regulatory oversight (Exh. 17a, at 54). The Department also appointed a

new Division Director. The new leadership and staff were able to implement immediate

action and set clear expectations with CMA going forward (Exh. 17a, at 54). Since the

Dynamic Risk report, the Division has continued to retain fully qualified inspectors and hire

additional staff. Through increased staffing, the Division has been able to provide stronger

regulatory oversight.

Additionally, the Dynamic Risk report made assessments of the current safety of

pipeline infrastructure throughout the Commonwealth. As a result of these assessments, the

Department issued a letter on January 31, 2020, requesting action plans from each natural

gas operator as to how the Dynamic Risk recommendations would be implemented in their

distributions systems (Exh. 8). On February 28, 2020, each natural gas operator submitted

their plans, which were reviewed by the Department. On July 7, 2021, the Department

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issued a second letter requesting updates on the status of each Dynamic Risk

recommendation. On July 21, 2021, each natural gas operator submitted their status updates,

which were again reviewed by the Department (Exh. 9).

E. API-1173 and Professional Engineer Regulations

Following the Incident in Merrimack Valley, the Department ordered CMA to adopt

the American Petroleum Institute’s (“API”) Recommended Practice 1173, a safety

management system (Exh. 1, at 29). On November 21, 2018, the Baker-Polito

Administration announced that NGA had adopted API-1173 to help pipeline operators create

a framework for developing a comprehensive, process-oriented approach to safety,

emphasizing continual assessment and improvement (Exh. 2, at 118). When applied, API-

1173 helps to reveal threats to distribution systems, manage risk, and promote a learning

environment that drives continuous improvement and safety. On April 24th, 2019, The

Blacksmith Group, an NGA selected company, began implementing API-1173 across all

participating members. Since then, consistent with the recommendations of NGA, all of the

natural gas operators in Massachusetts, including CMA, have adopted API-1173 and are in

the final stages of implementation.

Following its investigation, NTSB issued P-18-5, a Safety Recommendation to the

Commonwealth of Massachusetts to remove the PE licensure exemption for public utility

work (Exh. 1 at 48). An additional recommendation, P-18-6, was issued to the parent

company of CMA, NiSource, recommending PE approval of all natural gas projects moving

forward (Exh. 1 at 48).

On December 31, 2018, Governor Baker signed into law An Act Further Providing

for the Safety of the Commonwealth’s Natural Gas Infrastructure, Chapter 339 of the Acts of

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2018, , Section 2 of the act requires the stamp of a PE stamp on “any engineering plans or

specifications for engineering work or services that could pose a material risk to public

safety.”

On February 18, 2021, the Department opened a rulemaking, docket 21-04-A, for the

purpose of adopting uniform requirements regarding the use of PEs by local gas distribution

companies, pursuant to G.L. c. 164, § 148. After receiving comment from interested

stakeholders, on September 21, 2021, the Department issued an Order adopting final

regulations requiring a PE stamp. See Investigation of the Department of Public Utilities

Instituting a Rulemaking to Establish Requirements for Use of Processional Engineers for

Gas Utility Work, D.P.U. 21-04, Order Adopting Final Regulations (2021).

VII. DEPARTMENT PROCEEDINGS

A. D.P.U. 19-140 and D.P.U. 19-141

On October 25, 2019, following the release of the NTSB final report, the Department

opened an investigation into CMA’s responsibility for and response Incident as well as

CMA’s subsequent restoration efforts. This docket encompassed the findings of the

Division’s prior investigations and inspections conducted during and post restoration,

including those where Exit Letters had previously issued. See Investigation by the

Department of Public Utilities on its own Motion into Bay State Gas Company d/b/a

Columbia Gas of Massachusetts’ responsibility for and response to the September 13, 2018

Merrimack Valley Incident, D.P.U. 19-140, (2020).

That same day, the Department also opened an investigation into CMA’s efforts to

prepare for and restore service following the September 13, 2018 incident. See Investigation

by the Department of Public Utilities on its own Motion into the Preparation and Response of

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Bay State Gas Company d/b/a Columbia Gas of Massachusetts with respect to the September

13, 2018 Merrimack Valley Gas Event, D.P.U. 19-141, (2020). As part of each

investigation, the Department solicited comments from interested stakeholders. During its

investigation, the Department held public hearings on January 29, 2020, in Lawrence,

Massachusetts; and February 10, 2020, in Andover, Massachusetts. The Department

received numerous written and oral comments for each docket regarding the community

impact the events of September 13, 2018 had on the Merrimack Valley.

Through its investigation on D.P.U. 19-140, the Department determined CMA had

violated several additional state and federal regulations. The Department determined that the

over-pressurization occurred during the tie-in of two low pressure mains (Exh 18, at 1).

CMA failed to account for and relocate the sensing lines from the pipeline to be abandoned

to the pipeline being placed into service. As a result, high-pressure was introduced into the

low-pressure distribution system downstream of the South Union St. at Winthrop St.

Regulator Station. In addition, CMA personnel monitoring the distribution system pressure,

failed to have adequate qualifications to identify an AOC for the start-up of the new pipeline

in violation (Exh. 18, at 2). This was in violation of Part 192 § 192.805(h), which requires

after December 16, 2004, gas operators shall provide training, as appropriate, to ensure that

individuals performing covered tasks have the necessary knowledge and skills to perform the

tasks in a manner that ensures the safe operation of pipeline facilities.

The Department also found that CMA failed to deploy measures either through

physical or procedural actions to mitigate the control of any AOCs either at the site where

the tie-in occurred or at the South Lawrence district regulator station at South Union St. and

Winthrop St. During the tie-in process, Construction and Maintenance (“C&M”) crews

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should have measures in place to identify possible AOCs that may occur during the

construction of new pipelines. During the over-pressurization, CMA was unaware that high

pressure had entered the low-pressure distribution system. The use of gauges on the main

being placed in service would have shown an over-pressurization of the low-pressure

distribution system (Exh. 18, at 2). CMA failed to have adequate procedures or did not

follow its procedures for the startup of the newly installed plastic pipeline, in violation of

Part 192, § 192.605(b)(5), which requires gas operators to have a manual that includes

procedures for starting up and shutting down any part of the pipeline in a manner designed to

assure operation within the MAOP limits, plus the build-up allowed for operation of

pressure-limiting and control devices.

At the time CMA reported the Incident to the Department, the Department inquired as

to the status of the distribution system and was told that CMA was having difficulty with one

or more of its critical valves necessary to obtain a complete shutdown of the system. This

was reiterated over the course of several hours through the night. Complete shutdown was

not obtained until early the next morning (Exh. 18 at 3). This was in violation of Part 192, §

192.747(a), (b), which outlines servicing requirements for valve maintenance on distribution

systems.

Since CMA failed to maintain its critical valves, it could not ensure complete

shutdown of the distribution system when necessary. Had all critical valves been monitored

and maintained, the complete isolation of the low-pressure distribution system may have been

achieved sooner.

Each operator of a distribution system must protect its distribution system from

over-pressurization. This can be accomplished by providing over-pressure protection devices

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that stop the flow of gas or allow the gas to vent. In the low-pressure distribution system in

the Merrimack Valley incident area, CMA elected to use “retention type over-pressure

protection devices” to prevent over-pressurization of the low-pressure distribution system.

This was a violation of Part 192, § 192.195(b)(1), (2), which requires each distribution

system supplied from a source of gas that is at a higher pressure than the MAOP for the

system must have pressure regulation devices capable of meeting the pressure, load, and

other service conditions that will be experienced in normal operation of the system, and that

could be activated in the event of failure of some portion of the system. The pressure

regulation devices must also be designed so as to prevent accidental over-pressuring. The

devices used by CMA did not meet these criteria.

CMA’s design of its district regulator stations failed to prevent the over-pressurization

of the low-pressure distribution system in the Merrimack Valley incident area (Exh. 18,

at 3-4). The Department also found CMA did not have a knowledge base of its district

regulation stations in violation of Part 192, § 192.1007(a)(3).

The Department also found that CMA failed to comply with the federal code in

developing and implementing a plan to obtain knowledge of its district regulator stations by

August 2011 in violation of Part 192, § 192.1005. This requirement was not met until after

the over-pressurization on September 13, 2018 (Exh. 18, at 4-5).

B. Acquisition of CMA Assets

On July 2, 2020, Eversource, Eversource Gas Company of Massachusetts

(“EGMA”), NiSource, and CMA filed a petition jointly with the Department for approval of

the sale of substantially all of CMA’s assets to Eversource pursuant to G.L. c. 164, § 96.

See Joint Petition of Eversource Energy, NiSource Inc., Eversource Gas Company of

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Massachusetts, and Bay State Gas Company d/b/a Columbia Gas of Massachusetts for

approval by the Department of Public Utilities of Purchase and Sale of Assets, D.P.U 20-59,

(2020). As part of the Department’s Final Order, CMA was ordered to pay $56 million in

lieu of penalty to fund the establishment of an “Energy Relief Fund” comprising two

components: the “Merrimack Valley Renewal Fund” and the “Arrearage Forgiveness Fund”

The Merrimack Valley Renewal Fund would be directed toward energy efficiency and clean

energy measures for the benefit of residents, businesses, and municipal governments within

the City of Lawrence, the Town of Andover, and the Town of North Andover. The

Arrearage Forgiveness Fund would benefit certain low-income customers in Merrimack

Valley. D.P.U. 20-59, at 35.

In addition, the Department accepted a Consent Order executed between CMA and the

Division resolving all enforcement actions associated with Merrimack Valley in D.P.U. 19-

140 and D.P.U. 19-141, as well as all other pending CMA enforcement matters before the

Division. D.P.U. 20-59 at 63. To resolve the outstanding enforcement actions, CMA

agreed to a $12 million payment in lieu of penalty. CMA further agreed to certain

compliance actions, and any outstanding compliance action after the closing of the sale

became the responsibility of Eversource and EGMA. D.P.U. 20-59, at 63. The Final Order

authorizing the sale was executed on October 7,2020, concluding the Department’s

investigation into the Merrimack Valley incidents.

VIII. CONCLUSION

The events of September 13, 2018 severely impacted businesses and disrupted the

lives of residents of North Andover, Andover, and Lawrence. Approximately 11,000 people

were evacuated from their homes on September 13, 2018 and were not allowed to begin to

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return home until 7:00 a.m. on September 16, 2018. National Grid, who is the electrical

utility provider for the Merrimack Valley, restored power to the affected area between

September 14th and September 16th. As reflected in the public comments submitted during

the Department’s investigations, the impact of this incident caused lasting physical and

emotional trauma to the impacted residents and business owners in Merrimack Valley.

Since the Incident, the Department has overseen extensive restoration efforts in

Merrimack Valley. The Department ordered CMA to provide $56 million in funds to help

support further recovery efforts of those impacted. Specifically, $12 million dollars went to

resolving violations of state and federal pipeline safety laws. Additionally, the Department

adopted regulations requiring a PE stamp on all complex projects to enhance public safety.

The actions of the Legislature and Governor have devoted more resources to the Department

to ensure that the Division continues regulatory oversight of all gas operators in the

Commonwealth. With the additional resources, the Department continues its work to change

pipeline safety culture and prioritize public safety.

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