The ugly reality of Red Hill has risen to the surface once again, and it’s much worse than previously divulged.

The Pentagon’s Inspector General released reports on flaws and failures with the Navy’s Red Hill Fuel Facility and adjacent water systems on Thursday, with disturbing details on the poor documentation and lack of preparation that plagued the Navy as disaster loomed.

Among the most damning findings: When Navy drinking water was contaminated by jet fuel spilled at Red Hill in 2021, key Navy officials did not know a well serving Navy residences was close to the Red Hill fuel storage and pipeline structure. Joint Base Pearl Harbor Hickam (JBPHH) commander Capt. Erik Spitzer — who on Nov. 29, 2021, soon after a major leak, told residents that “there are no immediate indications that the water is not safe” — did not know there was a well at all.

In fact, the Red Hill well was physically part of the facility. And so when the November 2021 fuel spill from a facility pipeline reached the well after an earlier May breach, the diesel fuel contaminated the Navy’s water system, leading more than 6,000 to seek medical attention.

The fuel spilled into Red Hill’s water well followed a convoluted path that included a chain of mishaps and mistakes: an incomplete cleanup from the May 2021 spill, with thousands of gallons of fuel leaking into Red Hill’s fire suppression system; fire suppression piping made of inadequate and unsanctioned PVC, rather than the mandated steel; and a worker’s rupture of the fuel suppression pipe, made possible because of the PVC piping.

Further, and incredibly, despite reports from previous safety simulations to the contrary, investigators learned that 2021 “spill plans” completely ignored the possibility of fuel breaching the facility, while many Red Hill personnel had no knowledge of, or training in, any emergency response plan.

The cascade of damning facts exposed by these reports bolsters a $1.2 billion claim against the Navy by Honolulu Board of Water Supply (BWS), for costs the BWS was forced to incur to protect Oahu’s drinking water from contamination. The claim, filed in October 2023, is largely tied to replacing BWS’ Halawa Shaft, as well as two smaller wells. In September, the BWS was “still waiting” for a formal reply from the Navy, while delay increased the likelihood that a federal lawsuit would be filed.

Two other findings in the report also boggle the mind. In May 2018, the Navy partially shut down parts of Red Hill’s fire suppression system— without informing Navy employees or contractors working inside the facility. And in March 2022, the Occupational Safety and Health Administration (OSHA), issued a notice to Navy officials for a “serious” violation: disabling the fire suppression system for the 12-million gallon fuel storage tanks, while welding and hot work on the tanks and nearby area were ongoing, without any alternative firefighting measures in place.

While Red Hills tanks have been drained, and the facility is being shut down, the Pentagon’s new findings have ongoing pertinence. Red Hill is not the only locus of risk: There are 23 miles of fuel pipelines crossing JBPHH. All of the military’s fuel pipeline and safety systems need careful inspection and maintenance, and delivering on these expectations should not be subject to commanders’ discretion, but rather mandatory and reported on regularly.

Further, the Navy’s dithering with federal, state and local officials must end over safety issues, with an agreement on regular testing, and a conclusive plan to mitigate damage and ensure Oahu’s continuing water safety.

The Inspector General’s report makes 38 recommendations — among them a review of possibly illegal action attached to the use of PVC pipes rather than the steel required by contract, when installing Red Hill’s $50 million fire suppression system.

One report suggestion that should be taken up immediately: Appointment of a dedicated fueling officer to create continuity and clear channels of communication between stakeholders — water users on Oahu — and the military.

Another concern is that the cycling of military personnel not only provides opportunities for failures in maintaining communication and urgency, but also allows culpable figures to choose to remain silent over dangerous conditions, opting to leave the scene before mistakes are discovered. Consequences for mishandling command and management cannot be allowed to evaporate in cases like this, where widespread disaster could be — and has been — a result.

That’s a major concern articulated well by Navy whistleblower Lt. Cmdr. Shannon Bencs, a Red Hill fuel director who was removed from her duties in 2022 after raising alarms over fuel leaks. As she correctly points out, no one has been held formally accountable for repeated failures to detect or correct violations of Department of Defense standards, Navy orders, or state and federal laws.

“Someone needs to go to jail, in my opinion,” Bencs said.

A criminal investigation is certainly called for. With the consequences at stake — a $2 billion cleanup and closure operation, and the lingering potential for widespread toxic contamination or other massive disaster — the military’s public responsibility calls for no less.