This is another incident involving hot-gas defrost and liquid hammering effect causing a large diameter pipe to fail and releasing 183 pounds of NH3. This failure actually occurred inside the building (vs the 2010 Mobile, AL hammering release occurred on the roof of the building) and had far-reaching and serious consequences.

Respondent owns and operates the poultry processing facility which includes various equipment and processes associated with food preparation, packaging, and transportation. At the Facility, the Respondent utilizes a refrigeration system to ensure processed food is maintained at safe temperature prior to, and during, shipment. The refrigeration system uses anhydrous ammonia as a coolant. Emissions of regulated substances or other extremely hazardous substances are possible from the Facility or the equipment located therein. The refrigeration system at the Facility is a single process with more than 10,000 pounds of anhydrous ammonia making it a covered process subject to the requirements of 112(r)(7) of the Clean Air Act and the implementing regulations at 40 C.F.R. Part 68. On April 22, 2016, maintenance work was performed at the Facility. Specifically, a maintenance worker replaced a belt on a spiral freezer. The worker utilized a written standard operating procedure ("SOP") in performing the work. To safely perform the belt replacement maintenance the worker turned off the spiral freezer, which was in defrost mode at the time. The defrost cycle was interrupted when the freezer power was turned off. According to Respondent and the spiral freezer manufacturer, the spiral freezer requires routine and uninterrupted defrosting for proper performance.

Upon completion of the maintenance work, the worker restored power to the spiral freezer, which returned to a defrost mode. The following day, April 23, 2016, the spiral freezer was re-started and returned to use. Workers operating the spiral freezer were unaware of the interruption to the defrost cycle due to the belt replacement that occurred the previous day.

During the loss of power, caused by the maintenance work, and subsequent interruption of the defrost cycle, gas built up in the ammonia system relating to the spiral freezer. Soon after the spiral freezer was returned to service, hydraulic hammering, caused by the built-up gas, began in the ammonia piping related to the spiral freezer. The hammering weakened the weld on an end cap to the point where it failed. The end cap of a 16" ammonia pipe fell off onto the protective floor spilling ammonia into a production area where employees were present. Ammonia alarms sounded and the Facility was evacuated.

Upon mustering at designated points outside the Facility (per the Facility emergency plan) it was determined that one employee was missing. Pursuant to the emergency plan predesignated workers entered the Facility to search for the missing worker who was found unconscious near the ruptured ammonia pipe.  The emergency plan identified that Facility emergency responders needed self-contained breathing apparatus ("SCBA") equipment to enter the Facility during releases of ammonia. SBCA equipment was available for all emergency responders at the Facility. One employee, an emergency responder, however, only put on an air purifying respirator ("APR") to enter the building.

Eight employees were sent to the hospital of whom seven were released after observation and/or treatment for non-serious injuries. One employee, who was directly adjacent to the ammonia spill, required hospitalization. Doctors induced a coma and the worker was attached to a ventilator to provide breathing assistance for several weeks. The employee was subsequently released from the hospital.

Approximately 183 pounds of ammonia was released to the ambient air during the event. Ammonia inside the meat processing room was vented via fan to vents on the roof of the structure. Respondent performed an incident investigation to determine the causes and identify any performance issues relating to the incident and Respondent's responses to the incident. Respondent made the following conclusions:

  1. Respondent did implement a standard operating procedure for performing maintenance work on the spiral freezer; however, the SOP did not identify or address the hazard of interrupting the defrost cycle of the spiral freezer.
  2. The 16” end cap that was ejected from the end of the ammonia pipe was installed in October of 2014. At the time of installation, the welds were visually inspected and pressure tested. The materials used in constructing the weld in the piping system, related to the spiral freezer, were inadequate to maintain the integrity of the piping during hydraulic hammering, leading to the ejection of the end cap.
  3. The emergency plan requires that employees responding to the release of ammonia at the Facility wear SCBA equipment when entering the Facility. There was SCBA equipment available for all employees who might provide an emergency response to the release of ammonia; however, one employee entered the building wearing only the APR and not the required SCBA equipment.


  1. Respondent failed to adequately develop and implement written standard operating procedures relating to maintenance work on the spiral freezer. Specifically, Respondent failed to include procedures to preclude maintenance work from interrupting the defrost cycle of the spiral freezer in violation of 40 C.F.R. § 68.73(b).
  2. Respondent's welds on the spiral freezer ammonia piping system were not adequate to function as designed when hydraulic hammering within the piping system occurred on April 23, 2016 from an interrupted defrost cycle of the spiral freezer, as required by 40 C.F.R. § 68.73(f)(1).
  3. Respondent failed to implement written operating procedures relating to emergency activities at the Facility by not following the Facility emergency response plan in response to the incident at the Facility on April 23, 2016, in violation of 40 C.F.R. § 68.69(a)(1)(v).


Upon consideration of the entire record herein, including the Findings of Fact and Conclusions of Law, which are hereby adopted and made a part hereof, and upon consideration of the size of the business, the economic impact of the penalty on the business, the Respondent's full compliance history and good faith efforts to comply, the duration of the violation, payment by the violator of penalties previously assessed for the same violation, the economic benefit of noncompliance, the seriousness of the violation, and other factors as justice may require, EPA has assessed a civil penalty in the amount of one hundred and six thousand, eight hundred and ninety-four dollars ($106,894).



As a Condition of Settlement, Respondent agrees to the following:

  1. conduct comprehensive third-party Part 68 audits of twenty (20) facilities in Region 6, 
  2. the results of all external audits will meet the requirements for auditor independence, audit results and responses identified below.
  3. Potential RMP violations, or other areas of concern, will be specifically identified in each audit report; however, the report will also identify observations or improvement actions that are not necessarily violations. This document (the CAFO) does not in any way release violations of federal law identified as a result of these audits. EPA Region 6 reserves the right, in its discretion, to pursue enforcement of any violations of federal law identified as a result of these audits. Respondent does not admit to any violations identified in the audit reports and reserves all of its rights to contest any such findings, or in any subsequent action or proceeding.
  4. all audits, audit reports, and audit responses shall be completed within three years of the effective date of this CAPO.
  5. audits conducted pursuant to this settlement and any associated documents will be provided to Region 6 for any purpose, including forming the basis for an enforcement action.
  6. purchase one FLIR camera that will be used to detect leaks in RMP regulated processes at Respondent's RMP regulated facilities as part of the audit process at the 20 facilities identified above. Respondent will secure, whether through direct hiring or by contract, employees or contractors with appropriate experience and training to operate the FLIR camera and provide analysis of the FLIR camera imaging.
  7. FLIR imaging will be confined to the following external areas of each facility: 1. Condensing towers and associated valves and piping; and 2. Vessels (receivers and recirculators) and associated valves and piping. h. Respondent shall submit, as part of the audit of each facility, a brief report describing the nature and extent of releases found, and a description of the corrective actions taken to correct identified releases. Respondent shall also include a description of releases that were identified by the FLIR camera under this audit that may not have been identified as quickly had the FLIR technology not been utilized.

Condition - Ventless Ammonia System Pilot Project

  1. design and implement a pilot project to create a ventless closed ammonia system for a covered process at a Region 6 facility. One of Respondent's 40 covered processes in Region 6 will be fully re-piped and equipped to close the system from any ammonia releases to the ambient air from safety relief valves. Pressure relief valves will be re-piped within the new system and would "vent" to an ammonia diffusion tank that will capture and absorb ammonia that would have otherwise been released to the ambient air from the safety relief valve. Respondent has agreed to provide a report, described below, to EPA that will allow EPA to assess the proposed project.
  2. within 90 days of the effective date of this CAFO the Respondent shall submit a report to EPA Region 6 detailing design and engineering considerations, advantages - including safety and environmental benefits, risks to both human health and the environment from a ventless covered process as described by Respondent. This report shall be freely available to the public or any party upon request.
  3. Respondent will design and fully implement a pilot project, as described under this condition, at a facility of their choice in Region 6 within 24 months of the effective date of this CAFO.
  4. after 12 months of full operation of the pilot project the Respondent shall produce a second report that analyzes the project with an emphasis on creating lessons learned in design and construction and implementation of the pilot project and provide information about the type and quantity of releases that were avoided as a result of implementing the pilot project. This report shall be freely available to the public or any party upon request. Submittal of this second report to EPA shall complete the Ventless Ammonia System Pilot Project condition of this document.


Each audit shall have an audit leader ("Auditor") who meets the requirements of independence outlined below. Different standards shall apply to audit team members. Auditors shall be impartial and independent in conducting all third-party audit activities. Auditors shall receive no compensation or financial benefit from the outcome of the audit, apart from payment for auditing services. Auditors shall be: 

  1. knowledgeable with the requirements of 40 C.F.R. Part 68 and the implementing statute,
  2. experienced with the stationary source type and processes being audited and applicable recognized and generally accepted good engineering practices, and
  3. trained or certified in proper auditing techniques.

Auditors do not need to be registered Professional Engineers. The audit team does not require the participation of a Professional Engineer.

The respondent may not select an Auditor who has performed work for the Respondent within the last two years at the time of contract between the Auditor and Respondent.
For purposes of the preceding paragraph, the phrase "has performed work" shall not include being an auditor in an independent third-party audit that meets the requirements for independence as described in this document.

The respondent may not hire, as either employees or contractors, Auditors, or audit team members, for a period of two years following the submission of the final audit report from the Auditor to the Respondent. For purposes of the preceding paragraph, the term "hire, as either employees or contractors" shall not include being an auditor in an independent third-party audit that meets the requirements for independence as described in this document.

All Auditors, and audit team members, shall sign and date a conflict of interest statement verifying that they are eligible to perform the audit under the terms of this agreement. These requirements shall not apply to an organization that employs, or is owned by, an Auditor and in which an employee has performed work for the Respondent in the past two years where the organization ensures that such personnel do not participate in the audit, or manage or advise the audit team concerning the audit.

Retired employees who satisfy the requirements of independence may qualify as independent if their sole continuing financial attachments to the owner or operator are employer-financed or managed retirement and/or health plans.


Respondent shall ensure that the third-party

  1. Manages the audit and participates in audit initiation, design, implementation, and reporting,
  2. Evaluates the competency of audit team members, as applicable, to determine appropriate roles and responsibilities for the audit.
  3. Prepares the audit report and documents the full team's views and opinions in the final audit report, and
  4. Certifies the final audit report and its contents as meeting the requirements of this document.


Respondent shall ensure that the auditor prepares and submits an audit report that: 

  1. Identifies the lead auditor or manager, participating individuals, and any other key persons participating in the audit, including names, titles, and summaries of qualifications;
  2. Documents the auditor's evaluation of each process audited to determine whether procedures and practices developed by Respondent are adequate and being followed;
  3. Documents the findings of the audit, including any identified compliance or performance deficiencies. The Auditor shall also ensure that photographs and video recordings will be made of each audit to enhance understanding of the audit reports and provide context to the audit results. These photographs and video recordings shall be included in the audit reports submitted for each facility;
  4. Includes a summary of Respondent's comments on, and identify any adjustments made by the auditor to, any draft audit report provided by the auditor to Respondent for review or comment; and e. Include the following certification, signed and dated by the auditor or supervising manager for the audit:

I certify that this compliance audit report was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information upon which the audit is based. I further certify that the audit was conducted and this report was prepared pursuant to all applicable auditing, competency, independence, impartiality, and conflict of interest standards and protocols. Based on my personal knowledge and experience, the inquiry of personnel involved in the audit, the information submitted herein is true, accurate, and complete. I am aware that there are significant penalties for making false material statements, representations, or certifications, including the possibility of fines and imprisonment for knowing violations.

The auditor shall submit the audit report, including all draft and final copies, to the EPA Region 6 and the Respondent at the same time. The audit report and related records, including any documents reviewed, cited, or relied on the audit team in undertaking the audit, shall not be privileged as attorney-client communications or attorney work products, even if written for or reviewed by legal staff.

As soon as possible, but no later than 90 days after receiving the final audit report, Respondent shall determine an appropriate response to each of the findings in the audit report, and develop and provide to EPA Region 6 a findings response report that includes:

  1. A copy of the final audit report;
  2. An appropriate response to each of the audit report findings;
  3. A schedule for promptly addressing deficiencies; and
  4. A certification, signed and dated by Respondent's senior corporate officer or other official in an equivalent position, stating:

I certify under penalty of law that the attached compliance audit report was received, reviewed, and responded to under my direction or supervision by qualified personnel. I further certify that appropriate responses to the findings have been identified and deficiencies were corrected, or are being corrected, as documented herein. Based on my personal knowledge and experience, or inquiry of personnel involved in evaluating the report findings and determining appropriate responses to the findings, the information submitted herein is true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.

Respondent shall implement the schedule to address deficiencies identified in the audit findings response report. Respondent shall document the actions taken to address each deficiency, along with the date completed. If deficiencies are corrected prior to the response report then they may be included in that document. If deficiencies are corrected after submittal of the response report then those actions should be identified under separate letter, as they occur. Respondent shall retain all copies of draft and final audit reports, including associated documents, for a period of five years from the date of the final audit report, and provide any audit reports or documents to EPA Region 6 upon request.



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