Inspection Detail

Inspection: 313648685 - Valero Refinery

Inspection Information - Office: Labor Enforcement Task Force (Letf) Unit - Central

Investigation Summary

At approximately 8:00 a.m. on July 17, 2013, Employee #1 was assigned to drop the bottom head on coke drum B for maintenance on the head alignment pins. Drum B had previously been cleaned and emptied and the head was reinstalled. It was during that process that the flaw in the alignment pins was discovered. When Employee #1 and a coworker began the job, they noticed electricians working in the area of the coke pit, where the coke drums would drain. The drum was empty, but Employee #1 and the coworker were aware that there would be hot condensate in the drum. Employee #1 and the coworkers, not wanting to disrupt the electricians, decided to drain drum #B by using an unwritten procedure only used when the drain lines were plugged. This process would allow the hot condensate to drain on the deck and not interfere with the electricians. Employee #1 began lowering the head on the bottom of drum #B using the hydraulic ram. The controller for the ram would usually be on a 25 ft leash allowing the operator to be out of the danger zone. Employee #1 was operating the controller from directly under drum #B. The hydraulic ram moved slowly, placing a cheater bar on the control lever. The coworker turned and walked away just as the hot condensate gushed out of the drum/head opening drenching Employee #1. The employee received 1st and 2nd degree burns to his upper and lower back. Employee #1 was taken to an area hospital, where he was treated and remained hospitalized.

Keywords: BURN, MAINTENANCE, INSTALLING, CLEANING, BACK, COKE DRUM