Form

Only questions labeled * are required.

What is the name of the Facility where the assessment will be conducted:*

What is the Legal Name of Facility:

What is the Company/Corporate Name of Facility*

(i.e. Chevron, ExxonMobil, Marathon, P66, etc...)

Our Assessments are available to all operating companies that would like to improve their Process Safety programs and/or are looking to improve their performance against API RP 751. Participation is not dependent upon membership. Please let us know if your company is an API member

API Member

Not an API Member

Membership Status Unknown

The actual, physical location of the facility to participate in the Assessment

Facility Street Address - PSSAP

Facility City - PSSAP

Facility state/province - PSSAP

Facility zip/postal code - PSSAP

Facility country - PSSAP

Company Website:

Please share URL

Who is the Primary Contact for this Assessment:
(Note: The individual must be an employee of the organization)

Primary Contact First and Last Name *

First Last

The Title/Position of the Primary Contact

Email of Primary Contact*

Is the address for the Primary Contact the same or different than the facility address?

Same

Different

Is the Address for the On-Site Contact the same or different from the Facility Address?

Same

Different

On average, how many full-time employees are on-site during a typical workday?

On average, how many contractors are on-site during a typical workday?

At this time the API PSSAP program offers multiple assessment options. Please select below which assessment approach you would like us to conduct at your facility.

General Assessment (a collection of 7 or more protocols)

Partial Assessment (1 to 6 selected protocol(s))

API RP 751 HF Assessment (Qualifies as the 3-year audit requirement)

Licensing the API protocols and receiving 6-year benchmarking. (Program Manager has more details)

You would like to talk with Program Manager to discuss options.

Please list the Year and Quarter that you would like us to target for this assessment, please follow the guidelines listed below to ensure the availability of our team members:

*For Assessments in the United States (Domestic) please plan at least 5-6 months in advance.
**For Assessments outside of the United States (International) please plan 9-10 months in advance.

Thank you for your interest in having an assessment conducted at your facility. Below you will see the current pricing for our program. If you have any additional information and/or questions, please enter them below. If not, please submit this form and a member of our team will be in contact with you.

The actual, physical location of the facility to participate in the Assessment

Who is the Primary Contact for this Assessment:(Note: The individual must be an employee of the organization)

Who is the Primary Contact for this Assessment:
(Note: The individual must be an employee of the organization)