Document No.

: HPCL-TBRA
Original Date: 21st March, 2019
HERITAGE PETROLEUM COMPANY LIMITED Revision No.: 01
TASK BASED RISK ASSESSMENT (TBRA) Effective Date: 29th November, 2021
Document Tier: Tier 3
1. Prepared By (Performing Authority & Task Based Risk Assessment Team Members):
PROBABILITY/ LIKELIHOOD OF IMPACT OCCURRING

Start Date: Expiry Date:

Job Location: SEVERITY REMOTE UNLIKELY POSSIBLE LIKELY QUITE CERTAIN

JOB DESCRIPTION: A1 Medium A2 High A3 Major A4 Major A5 Major

B MAJOR A MASSIVE
SEVEN (7) CRITICAL ACTIVITIES TO REMEMBER BASED ON YOUR TBRA: B1 Medium B2 Medium B3 High B4 Major B5 Major
1. Prevent accidents and cases of work-related ill health (physical and mental) by managing the health and safety
risks in the workplace.
2. Ensure all Control Measures are in place as identified in this TBRA e.g., LOTOTO, PPE, SIMOPS, etc.
3. Provide clear instructions and information, and adequate training, to ensure employees are competent to do their
work. C1 Low C2 Medium C3 High C4 High C5 High

C MODERATE
4. Engage and consult with employees on day-to-day health and safety conditions.
5. Implement Emergency and Evacuation Procedures – Muster Points, Eye Wash, Natural Disasters, etc.
6. Document if there is a change to scope of work, conditions on site, and/or unforeseen circumstances.
7. Maintain safe and healthy working conditions, provide, and maintain plant, equipment, and machinery, and
ensure safe storage/use of substances.
D1 Low D2 Medium D3 Medium D4 Medium D5 High

D MINOR
10 Life Saving Rules 14 Sources of Energy E1 Low E2 Low E3 Low E4 Medium E5 Medium

E SLIGHT
RANKING 1 2 3 4 5
1) SECURITY
EMERGENCY
CONTACT
2) HSSE
NUMBERS 3) MEDICAL
4) FIRE
 Document No.: HPCL-TBRA
Original Date: 21st March, 2019
HERITAGE PETROLEUM COMPANY LIMITED Revision No.: 01
TASK BASED RISK ASSESSMENT (TBRA) Effective Date: 22nd April, 2021
Document Tier: Tier 3
Job description: Gross Risk: Low (C1, D1, E1, E2, E3) Residual Risk: Low (C1, D1, E1, E2, E3)
Medium (A1, B1, B2, C2, D2, D3, D4, E4, E5) High (A2, Medium (A1, B1, B2, C2, D2, D3, D4, E4, E5) High (A2,
B3, C3, C4, C5, D5): B3, C3, C4, C5, D5):
Major (A3, A4, A5, B4, B5) Major (A3, A4, A5, B4, B5)

Hazards Hazard Description and Effect Gross Risk Controls Residual Risk Recommendations/ Actions
(Sources of Energy) Risk Severity Likelihood of Risk Rating Risk Severity Likelihood of Risk Rating
Occurrence Occurrence
 Document No.: HPCL-TBRA
Original Date: 21st March, 2019
HERITAGE PETROLEUM COMPANY LIMITED Revision No.: 01
TASK BASED RISK ASSESSMENT (TBRA) Effective Date: 22nd April, 2021
Document Tier: Tier 3
Instructions: Select, The level of Risk below. The single highest residual risk rating: determines the overall risk classification.
Level 1 Low Risk Level 2 Medium Risk Level 3 High Risk Level 4 Major Risk
PREPARED BY (PERFORMING AUTHORITY, AND RISK ASSESSMENT TEAM MEMBERS)
Name (BLOCK LETTERS): 1 2 3 4

Signature:

Position:

Date:

APPROVED BY
Name (BLOCK LETTERS)

Signature
Level 1 –
LOW Risk Date

Position Approving Authority (LEVEL 1 ACTIVITY) Issuing Authority (LEVEL 1 ACTIVITY) HSSE Designate (LEVEL 1 ACTIVITY)

Name (BLOCK LETTERS)

Signature
Level 2 –
MEDIUM Risk Date

Position Approving Authority (LEVEL 2 ACTIVITY) Issuing Authority (LEVEL 2 ACTIVITY) HSSE Designate (LEVEL 2 ACTIVITY)

Name (BLOCK LETTERS)

Signature
Level 3 –
HIGH Risk Date

Position Approving Authority (LEVEL 2 ACTIVITY) Approving Authority (LEVEL 2 ACTIVITY) HSSE Designate (LEVEL 2 ACTIVITY)

Level 4 – MAJOR – Risk DO NOT PROCEED. Team to be appointed by the CEO to reduce risk to ALARP.
 Document No.: HPCL-TBRA
Original Date: 21st March, 2019
HERITAGE PETROLEUM COMPANY LIMITED Revision No.: 01
TASK BASED RISK ASSESSMENT (TBRA) Effective Date: 22nd April, 2021
Document Tier: Tier 3
Risk Assessment - Work Party Declaration
For the purposes of meeting legal requirements with risk management, I declare stating that to the best of my knowledge and has made appropriate enquiries:
(a) Heritage has in place systems for ensuring compliance with all prudential requirements;
(b) The systems and resources that are in place for identifying, measuring, evaluating, monitoring, reporting, and controlling or mitigating material risks, and the risk management framework are appropriate to the institution, having regard to the size, business
mix and complexity of the institution and group (where appropriate).
(c) The Risk Management and internal control systems in place are operating effectively and are adequate having regard to the risks they are designed to control;
(d) Heritage has a RA that complies with these legislative requirements and Standard, and Heritage has complied with each measure and control described in the RA;
(e) Heritage is satisfied with the intended results of the processes and systems surrounding the operations as outlined in this Task Based Risk Assessment (TBRA) and that it meets our legal and site safety requirements at this time s dated.

No. NAME DESIGNATION DATE SIGNATURE

1

10

11

12
HERITAGE
RISK
HERITAGE PETROLEUM COMPANY LIMITED
RISK ASSESSMENT 5X5 MATRIX
ED
 1
1 2
2 3
3 4
4 5
LOW MEDIUM HIGH MAJOR
C1 A1 A2 A3 Biological threats
E1 B2 C3 A5 Body Mechanics
E2 C2 C4 B4 Toxic Substances
E3 D2 C5 B5 Gravity (falling/dropped objects)
A1 D3 D5 A4 Hazardous Materials
B1 D4 B3 Radiation
B2 E4 Pressure Energy
C2 E5 Noise Impacts
D2 B1 Thermal Energy
D3 Human Factors
D4 Weather Factors
E4 Mechanical Energy
E5 SIMOPS Issue
A2 Chemical Energy
B3 Electrical
C3 Other (detail under description)
C4
C5
D5
A3
A4
A5
B4
B5
 Document No.: HPCL-TBRA-
Original Date:
HERITAGE PETROLEUM COMPANY LIMITED Revision No.:
TASK BASED RISK ASSESSMENT (TBRA) Effective Date:

Document Tier: Tier 3

TBRA Document ID #:

Date: (DD/MM/YYYY) Expiry Date: (DD/MM/YYYY)

TBRA Title:

Work Location:

Location Description:

Job Description:
First Last First Last
TBRA Facilitator(s): Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:

TBRA HAZARDS – (Task based hazards, Process based hazards and Jobsite based Hazards)
Sources of Energy - The Hazards directly related to performing the tasks or the tools and equipment being used or with the Process or with the Jobsite.

Heritage 10 Life Saving Rules

Bypassing Safety Confined Space Driving Energy Isolation Hot Work Line of Fire Safe Mechanical Lifting Work Authorization Working at Height Ground Disturbance
Controls

Compliance Obligations
Applicable compliance obligation for the Job. (e.g., OSHA , EMA Water Pollution Rule)
 Document No.: HPCL-TBRA-

HERITAGE PETROLEUM COMPANY LIMITED Original Date:

Revision No.:

TASK BASED RISK ASSESSMENT (TBRA) Effective Date:

Document Tier: Tier 3

Job description:

Hazards Gross Risk Residual Risk Additional Recommendations/

(Sources of Energy) Hazard Description Hazard Effect Severity Likelihood
Risk Control Description Severity Likelihood
Risk
Actions
Rating Rating

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation Administrative PPE

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(Sources of Energy) Hazard Description Hazard Effect Risk Severity Likelihood of Risk Rating Control Description Risk Severity Likelihood of Risk Rating Actions
Occurrence Occurrence

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation
Administrative PPE

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Hazards Gross Risk Residual Risk Additional Recommendations/
(Sources of Energy) Hazard Description Hazard Effect Risk Severity Likelihood of Risk Rating Control Description Risk Severity Likelihood of Risk Rating Actions
Occurrence Occurrence

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation
Administrative PPE

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 Document No.: HPCL-TBRA-
Original Date:
HERITAGE PETROLEUM COMPANY LIMITED Revision No.:
TASK BASED RISK ASSESSMENT (TBRA) Effective Date:
Document Tier: Tier 3
Instructions: Select, The level of Risk below. The single highest residual risk rating extracted from the TBRA, determines the overall risk classification.

Low Risk Medium Risk High Risk Major Risk A5

PREPARED BY RISK ASSESSMENT FACILITATOR AND TEAM MEMBERS
Name (Block Letters): 1 2 3 4 5

Signature:

Job Position:
(RA Facilitator)
Date (DD/MM/YYY):

APPROVED BY
Name (BLOCK LETTERS)

Signature

LOW Risk Date

Position
Approving Authority (LEVEL 1 ACTIVITY) Issuing Authority (LEVEL 1 ACTIVITY) HSSE Designate (LEVEL 1 ACTIVITY)
Name (BLOCK LETTERS)

Signature

MEDIUM Risk Date

Position
Approving Authority (LEVEL 2 ACTIVITY) Issuing Authority (LEVEL 2 ACTIVITY) HSSE Designate (LEVEL 2 ACTIVITY)
Name (BLOCK LETTERS)

Signature

HIGH Risk Date

Position
Approving Authority (LEVEL 3 ACTIVITY) Issuing Authority (LEVEL 3 ACTIVITY) HSSE Designate (LEVEL 3 ACTIVITY)

MAJOR Risk DO NOT PROCEED. Team to be appointed by the CEO to reduce risk to ALARP.
 Document No.: HPCL-TBRA-
Original Date:
HERITAGE PETROLEUM COMPANY LIMITED Revision No.:
TASK BASED RISK ASSESSMENT (TBRA) Effective Date:

Document Tier: Tier 3

TBRA Document ID #:

Date: (DD/MM/YYYY) Expiry Date: (DD/MM/YYYY)

TBRA Title:

Work Location:

Location Description:

Job Description:
First Last First Last
TBRA Facilitator(s): Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:

TBRA HAZARDS – (Task based hazards, Process based hazards and Jobsite based Hazards)
Sources of Energy - The Hazards directly related to performing the tasks or the tools and equipment being used or with the Process or with the Jobsite.

Heritage 10 Life Saving Rules

Bypassing Safety
Confined Space Driving Energy Isolation Hot Work Line of Fire Safe Mechanical Lifting Work Authorization Working at Height Ground Disturbance
Controls

Compliance Obligations
Applicable compliance obligation for the Job. (e.g., OSHA , EMA Water Pollution Rule)
 Document No.: HPCL-TBRA-

HERITAGE PETROLEUM COMPANY LIMITED Original Date:

Revision No.:

TASK BASED RISK ASSESSMENT (TBRA) Effective Date:

Document Tier: Tier 3

Job description:

Hazards Gross Risk Residual Risk Additional Recommendations/

(Sources of Energy) Hazard Description Hazard Effect Severity
Risk
Likelihood Rating
Control Description Severity
Risk
Likelihood Rating Actions

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation Administrative PPE

1. TASK STEP:
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2. TASK STEP
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Hazards Gross Risk Residual Risk Additional Recommendations/
(Sources of Energy) Hazard Description Hazard Effect Risk Severity Likelihood of Risk Rating Control Description Risk Severity Likelihood of Risk Rating Actions
Occurrence Occurrence

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation Administrative PPE

11. TASK STEP

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Hazards Gross Risk Residual Risk Additional Recommendations/
(Sources of Energy) Hazard Description Hazard Effect Risk Severity Likelihood of Risk Rating Control Description Risk Severity Likelihood of Risk Rating Actions
Occurrence Occurrence

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation Administrative PPE

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 Document No.: HPCL-TBRA-
Original Date:
HERITAGE PETROLEUM COMPANY LIMITED Revision No.:
TASK BASED RISK ASSESSMENT (TBRA) Effective Date:
Document Tier: Tier 3
Instructions: Select, The level of Risk below. The single highest residual risk rating extracted from the TBRA, determines the overall risk classification.

Low Risk Medium Risk High Risk Major Risk

PREPARED BY RISK ASSESSMENT FACILITATOR AND TEAM MEMBERS
Name (Block Letters): 1 2 3 4 5

Signature:

Job Position:
(RA Facilitator)
Date (DD/MM/YYY):

APPROVED BY
Name (BLOCK LETTERS)

Signature

LOW Risk Date

Position
Approving Authority (LEVEL 1 ACTIVITY) Issuing Authority (LEVEL 1 ACTIVITY) HSSE Designate (LEVEL 1 ACTIVITY)
Name (BLOCK LETTERS)

Signature

MEDIUM Risk Date

Position
Approving Authority (LEVEL 2 ACTIVITY) Issuing Authority (LEVEL 2 ACTIVITY) HSSE Designate (LEVEL 2 ACTIVITY)
Name (BLOCK LETTERS)

Signature

HIGH Risk Date

Position
Approving Authority (LEVEL 3 ACTIVITY) Issuing Authority (LEVEL 3 ACTIVITY) HSSE Designate (LEVEL 3 ACTIVITY)

MAJOR Risk DO NOT PROCEED. Team to be appointed by the CEO to reduce risk to ALARP.
 Document No.: HPCL-TBRA-
Original Date:
HERITAGE PETROLEUM COMPANY LIMITED Revision No.:
TASK BASED RISK ASSESSMENT (TBRA) Effective Date:

Document Tier: Tier 3

TBRA Document ID #:

Date: (DD/MM/YYYY) Expiry Date: (DD/MM/YYYY)

TBRA Title:

Work Location:

Location Description:

Job Description:
First Last First Last
TBRA Facilitator(s): Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:
First Last First Last
TBRA Team members: Name: Name: Name: Name:

TBRA HAZARDS – (Task based hazards, Process based hazards and Jobsite based Hazards)
Sources of Energy - The Hazards directly related to performing the tasks or the tools and equipment being used or with the Process or with the Jobsite.

Heritage 10 Life Saving Rules

Bypassing Safety Confined Space Driving Energy Isolation Hot Work Line of Fire Safe Mechanical Lifting Work Authorization Working at Height Ground Disturbance
Controls

Compliance Obligations
Applicable compliance obligation for the Job. (e.g., OSHA , EMA Water Pollution Rule)
 Document No.: HPCL-TBRA-

HERITAGE PETROLEUM COMPANY LIMITED Original Date:

Revision No.:

TASK BASED RISK ASSESSMENT (TBRA) Effective Date:

Document Tier: Tier 3

Job description:

Hazards Gross Risk Residual Risk Additional Recommendations/

(Sources of Energy) Hazard Description Hazard Effect Severity Likelihood
Risk Control Description Severity Likelihood
Risk
Actions
Rating Rating

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation Administrative PPE

1. TASK STEP:
●
●
●
●

2. TASK STEP
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●
●

3. TASK STEP
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4. TASK STEP
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Hazards Gross Risk Residual Risk Additional Recommendations/
(Sources of Energy) Hazard Description Hazard Effect Risk Severity Likelihood of Risk Rating Control Description Risk Severity Likelihood of Risk Rating Actions
Occurrence Occurrence

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation
Administrative PPE

11. TASK STEP

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Hazards Gross Risk Residual Risk Additional Recommendations/
(Sources of Energy) Hazard Description Hazard Effect Risk Severity Likelihood of Risk Rating Control Description Risk Severity Likelihood of Risk Rating Actions
Occurrence Occurrence

HIERARCHY OF CONTROLS: ► Eliminate Substitute Engineering Isolation /

Segregation
Administrative PPE

21. TASK STEP

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 Document No.: HPCL-TBRA-
Original Date:
HERITAGE PETROLEUM COMPANY LIMITED Revision No.:
TASK BASED RISK ASSESSMENT (TBRA) Effective Date:
Document Tier: Tier 3
Instructions: Select, The level of Risk below. The single highest residual risk rating extracted from the TBRA, determines the overall risk classification.

Low Risk Medium Risk High Risk Major Risk

PREPARED BY RISK ASSESSMENT FACILITATOR AND TEAM MEMBERS
Name (Block Letters): 1 2 3 4 5

Signature:

Job Position:
(RA Facilitator)
Date (DD/MM/YYY):

APPROVED BY
Name (BLOCK LETTERS)

Signature

LOW Risk Date

Position
Approving Authority (LEVEL 1 ACTIVITY) Issuing Authority (LEVEL 1 ACTIVITY) HSSE Designate (LEVEL 1 ACTIVITY)
Name (BLOCK LETTERS)

Signature

MEDIUM Risk Date

Position
Approving Authority (LEVEL 2 ACTIVITY) Issuing Authority (LEVEL 2 ACTIVITY) HSSE Designate (LEVEL 2 ACTIVITY)
Name (BLOCK LETTERS)

Signature

HIGH Risk Date

Position
Approving Authority (LEVEL 3 ACTIVITY) Issuing Authority (LEVEL 3 ACTIVITY) HSSE Designate (LEVEL 3 ACTIVITY)

MAJOR Risk DO NOT PROCEED. Team to be appointed by the CEO to reduce risk to ALARP.