Medserv Egypt

Task Based Risk Assessment

Date: 08/01/24

1. Basic Work Details

Activity/Task: Full Depth Reclamation (FDR) Location: Site A – Road (1)
Procedure/SOP: ST04-01 Hazards & Effects Management SIMOPS: Yes/No Date: 05.01.2024
TBRA Author: Baher Abdelwahab Checked by Supervisor: Post use Supervisor review:
TBRA Team Members: Permit No(s): 1 Revision/Validity:
2. Hazard Identification Prompts
Physical Chemical Biological Environmental Electrical Ergonomic Other
• Temp. extremes ☐ • Haz. Substances ☐ • Insects ☐ • Noise ☐ • Electric shock ☐ • Manual handling ☒ • Fatigue ☐
• Trapped pressure ☐ • Fumes ☐ • Bacteria ☐ • Lone worker ☐ • Static electricity ☐ • Overreaching ☐ • Stress ☐
• Engulfment ☐ • Mists ☐ • Viruses ☒ • Poor/excessive light ☐ • Eddy currents ☐ • Pinch points ☐ • Mobile plant ☐
• Vibration ☐ • Vapours ☐ • Weather extremes ☐ • Faulty cables/leads ☐ • Sharp materials ☐ • Underground Services ☐
• Line of fire ☐ • Dust ☒ • Discharges to land ☐ • Non-intrinsically safe • Explosive Atmosphere ☐
• Trips/slips & falls ☐ • Oxygen deficiency/excess
• Discharges to air ☐ equipment ☐ • Radiation ☐
☐ ☐ ☐ • Multiple electrical feeds ☐
• Excavation • Discharges to water • Difficult rescue ☐
• Confined space ☐
• Chemical reaction ☐
• Soil contamination ☐ • Hidden cabling ☐ • Suspended loads ☐
• Transportation of
• Falling objects ☐ Substances ☐ • Soil erosion ☐ • Untrained people ☐
• Working at height ☐ • Waste ☐
• Burns (hot/cold) ☐
• Working near water ☐

`
3. Additional PPE Prompts
Safety Glasses Hard Hat Safety Shoes Gloves Coverall Mask Others:

4. Hazard Control Prompts

People Controls Equipment / Engineering Controls Environmental Controls Permits
Trained in the use of tools and equipment ☒ Lock out and tag systems ☐ Ventilation ☐ Hot Work/Cold Work ☒
Safety Watch/Observer ☒ Isolations ☐ Lighting ☐ Confined Space ☐
Barriers/ tape to isolate area ☒ Fire extinguisher ☒ Gas detection / monitoring ☐ Lifting Plan ☐
Warning signs ☐ Scaffolding for access ☐ Spill containment ☐ Work at height ☐
Other monitoring required (state type in #5) ☐ Appliances & Accessories Certifications ☐ Other: ☐

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

Brief Description of the Work Activity

This task-based risk assessment is for the purpose of handling and heavy equipment moving hazardous.

The following Task Based Risk Assessment Covers Activities/Area listed below
1 Use of forklift
2 Manual Handling for cement
3 Use FDR machine for recycling the soil
4 Use Pad foot compactor and soil compactor for density increasing
5 Use grader for levelling
General Control of Work requirements
1 Work site has been visited to check for any additional hazards introduced due to other activity or changes in the area
2 Permit has been approved for the activity to progress
3 Pre-start Toolbox Talk has been carried out including discussion of applicable Medserv Lifesaving Rules and signed by all the work party
4 This TBRA has been communicated alongside Toolbox Talk and signed by all the work party
5 Suitable and sufficient PPE is available and being worn by all work party
6 All pre-use inspection checklists have been completed for applicable equipment involved with work activity
7 All other associated checklists for hazardous activities have been completed and approved and attached with Permit
8 Emergency arrangements are in place in case of incident/accident inclusive of any required rescue plans
9 Site monitoring- identified supervision will be on site during work activity at all times

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

Hazard Initial Risk Controls Residual Risk

Likelihood
Job Steps Likelihood Potential
Hazard Description Population Potential Risk of Risk
of List all Controls Required Conseque
& Effect at Risk Consequence Rating Occurrenc Rating
Occurrence nce
e
Separate the job into Describe all hazards Name all types From matrix, From matrix, Classify Describe fully all controls applicable for each From From matrix, Classify risk
individual tasks and identified and their of personnel at identify identify risk hazard e.g. if PPE is used as a control, it must matrix, identify rating from
record in sequence. effects for each task risk. consequence severity with rating be specifically described. identify likelihood matrix for
Identify the tools and (from Hazard ID checklist Remember to with no controls no controls from If a control can only be verified by consequenc with each
equipment to be used and based on include people in place, for in place, for matrix documentation, then it must be available. e with controls in hazard.
and any planned hold observations and outside the for each controls place for
points where the job will experience). work party each hazard. each hazard. hazard. All controls must be valid in that they reduce each hazard.
severity, likelihood or both. in place, for
stop before progressing Note: Additional hazards who may be
to the next step. affected. each
may be caused by hazard.
interaction with other
work.
• No Coordination
• Unawareness of
Hazards
• Hazardous
1.Review TBRA through Toolbox Talk
Working
2.All work shall be stopped and re-evaluated
1. Planning of the Environment • By upon change to work sequence or method.
Task and • Lack of standers 3 B Medium 2 B Low
3.If the condition changes or if the scope of
Communication Communication
work changes, then the crew shall re-assess
• Failure of the hazards and revise TBRA hold TBT again.
Equipment
• No Permits
• Inexperienced
Workers
1.Ensure that all involved workers are
wearing personnel protective equipment,
• Personnel received job task briefing and start card, and
2. Using workers • Injures, slips. workers 3 B Medium 2 B Low
toolbox talk.

• Collision of 1. Develop traffic plan. Ensure that

Heavy pedestrian routes are established. One
equipment . Traffic way traffic systems to be used
3. Traffic with traffic or . Workers 3 B Medium wherever possible. 2 B Low
with
pedestrians.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

1. Construction equipment shall be

inspected for safety and proper
operation.
2. Only trained and competent operators
to operate the plant.
3. Ensure control of delivery drivers whilst
on site.
• Entrapment, 4. Ensure that they have the correct level
4. Moving crushing, of PPE to be present on site.
Vehicles and exposure to 5. Drivers and assistants to have brief site
Equipment high pressure . Workers 3 B Medium induction. 2 B Low
6. All moving Vehicles and heavy
equipment shall have a back-up alarm.
7. All machinery and equipment shall be
inspected daily to ensure safe operating
condition
8. Speed limits must be respected on the
job site for all vehicles.
9. No equipment shall be left with motor
running unattended by the driver.

1. All hand tools shall be in good

5. Using Hand • Pinch finger, repair and used only for the
Tools laceration or purpose for which designated.
injury . Workers 3 B Medium 2. All hand tools shall be inspected 2 B Low
tested for safe operation
conditions prior to use.

1. Use PEE Kit

• Breathing
6. Exposure to problems . Workers 3 B Medium 2 B Low
cement dust

• No Coordination All Workers / 1. Assess the operational area to identify

• Unawareness of Employees hazards and implement mitigation controls
Hazards prior to start the operation.
7. Planning of • Hazardous Working 2. Conduct pre-start TBT meeting with all
the Task and Environment 2 B Medium involved personnel prior to start the 1 B Low
Communicati
• Lack of operation, identifying hazards and discuss
on control measures prior to work.
Communication
• Failure of 3. Check all working equipment is in good
Equipment condition prior to use.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

• Inexperienced 4. Establish means of communication.

Crew 5. Consider weather conditions during
• Rushing into planning stage. Operation must not be
the Job executed during adverse weather
conditions.
6. Ensure all required PPE is available and in
good condition
7. Ensure one is using the correct postures
and movements when handling objects.
8. Object to be handled should not exceed
25kgs.
9. Get help where possible.

• Fatigue or Physical All Workers / 1. ensure that the object is light enough to lift,
difficulty Employees is stable and unlikely to shift or move.
• Pain or discomfort 2. heavy or awkward loads should be moved
during or after the using a handling aid.
task
3. make sure the route is clear of
• Low temperatures
obstructions.
• High winds
• Floor/ground is 4. make sure there is somewhere to put the
slippery, wet or not load down wherever it is to be moved to
level. 5. stand as close to the load as possible and
8. Manual • Stress - Wearing spread your feet to shoulder width.
handling on protective or thick 4 B Medium 2 B Medium
6. bend your knees and try and keep the
limited items clothing, affecting back's natural, upright posture.
comfort or handling.
7. grasp the load firmly as close to the body
• Ergonomic - as you can use the legs to lift the load in a
Working in
smooth motion as this offers more leverage
confined
reducing the strain on your back
spaces
8. carry the load close to the body with the
elbows tucked into the body.
2. Avoid twisting the body as much as
possible by turning your feet to
position yourself with the load.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

• No Coordination • Operators 1. Assess the operational area to identify

• Unawareness of • Supervisors
hazards and implement mitigation
Hazards controls prior to start the operation.
• Nearby
• Hazardous Working 2. Ensure that all required permits are
Environment Workers raised, signed and are in place.
• Lack of 3. Conduct pre-start TBT meeting with all
Operations
Communication involved personnel prior to start the
Mgr
• Failure of Equipment operation, identifying hazards and
• Inexperienced Crew discuss control measures prior to
• Inhalation work.
4. Check all working equipment is in
• No Permits
good condition prior to use, high
pressure pump checks including
mechanical and safety devices to be
9. Planning of carried out prior.
the Task and 5. Ensure all the equipment have valid
Communicatio High High High certification. Slight Low Low
n 6. Establish means of communication.
7. Designated Supervisor/Foreman for
task.
8. Consider weather conditions during
planning stage.
9. Ensure all required PPE is available
and in good condition.
10. Knowledge of closest first aid kit and
first aider.
11. Ensure no slip/trip hazards are present
in workspaces and walkways.
12. Always check the condition of tools
prior to use.
11- Faulty equipment must not be used.
Immediately report suspect
equipment or tools.
• Unauthorized • Operators 1. Use tools that are the right size & right
personnel setting- type for your job.
• Supervisors
up 2. Follow the correct procedure for using
• Connection failure • Nearby every tool.
• Use of Damaged Workers 3. Keep your cutting tools sharp and in
10. Selecting the Serious Medium High good condition. Major Medium Medium
tools
right tool Operations
• Use of Damaged 4. Don’t work with oily or greasy hands.
Mgr
equipment 5. Cut away from yourself when using
• Electric shock chisels and other edged tools.
• Trip hazards. 6. Handle sharp-edged and pointed tools
with care.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24
7. Always carry pointed tools by your side
with the points and heavy ends down.
8. Never carry tools in your pockets.
9. Do not use tools which are loose or
cracked.
10. Always place tools or materials where
they cannot fall or trip other personnel
when not in use.
11. Don’t force screws; make sure that the
correct screw or fixing for the job is
being used.
12. Where possible, secure work with
clamps or a vice, freeing both hands to
operate the tool used.
13. Keep your balance and proper footing
when working, being careful not to
overreach.
14- Ensure that the SWP is read.
• Operators 1. Wear correct PPE
• Supervisors 2. Pre-checks to be carried out prior to
task commencing.
• Nearby 3. Wear harness, pre-check condition.
Workers Should the hand tool be used at
height.
Operations
4. Adopt correct posture, keep in mind
Mgr
duration.
5. Watch hand placement
6. Ensure the user is properly trained.
• Burns 7. Use good quality tools.
• Electric shock 8. Keep tools in good condition at all
• Back strains. times.
11. Using hand • Pinch points Serious Medium High 9. Inspect tools for defects before use. Major Medium Medium
tools
• Fire Replace or repair defective tools.
• Lack of breathable air 10. Keep cutting tools sharp and cover
• Heat. sharp edges with a suitable covering to
protect the tool and to prevent injuries
from unintended contact.
11. Replace cracked, splintered, or broken
handles on files, hammers,
screwdrivers, or sledges.
12. Ensure that the handles of tools like
hammers and axes fit tightly into the
head of the tool.
13. Replace worn jaws on wrenches, pipe
tools and pliers.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24
14. Redress burred or mushroomed heads
of striking tools.
15. Pull on a wrench or pliers. Never push
unless you hold the tool with your palm
open.
16. Point sharp tools (e.g., saws, chisels,
knives) laying on benches away from
aisles and handles should not extend
over the edge of the bench top.
17. Maintain tools carefully. Keep them
clean and dry and store them properly
after each use.
18. Carry tools in a sturdy toolbox to and
from the worksite.
19. Wear safety glasses or goggles, or a
face shield (with safety glasses or
goggles) and well-fitting gloves
appropriate for the hazards to which
you may be exposed when doing
various tasks.
20. Keep the work environment clean and
tidy to avoid clutter which may cause
accidents.
21. Use a heavy belt or apron and hang
tools pointed down at your sides, not
behind your back.
22. Keep the workspace tidy. Store tools
properly when not in use.
23- Use the right tool for the job.
1. Ensure the loads are as close to the body
as possible prior to moving them.
2. Minimise twisting, stooping and reaching
movements as far as reasonably
Workers practicable.
Visitors 3. Reduce excessive movement of loads by
• Using incorrect
Team moving the operation closer to the
12-.Manual Handling techniques
Supervisors storage facility (where possible).
• Overexertion B Medium
4. Where possible have the employee dictate
3 A Low
Crew Members 3
• Body injury the rate of the process rather than a
piece of machinery.
5. Proper PPE to be used (safety shoes,
safety glasses, safety helmet, gloves
(anti cut 5 impact gloves) & cover all).
6. Lifting / lowering of the tools and
equipment must be within Project

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24
provided lifting bags, using gin wheels
in the dedicated lifting / lowering hard
barricaded locations
7. Lifting / lowering of the tool bags using gin
wheels to be completed by Rigger 2
only
8. No personnel are permitted within the
hard-barricaded lifting / lowering area
when in use
9. Use long bags up to 3 meters in length to
lift long items
10. Ensure that at least 75% of the length of
the item being lifted / lowered is inside
the bag
11. To safely lift longer material such as
scaffold poles, one end of the material
is inserted into the bag which provides
support for the bottom, then the rope is
secured to the handle of the bag and
tied with a hitch around the middle and
upper portion to secure the load and
keeping it upright
15- Material shall not be raised via the
lifting buckets and gin wheels that
have a combined weight in excess
of 25Kg.
• Operators 1. PPE and facilities suitable for the
hazardous materials known or
• Supervisors
suspected to be present for the
12. Hazardous • Heavy metals • Nearby waste generated from water
Waste and biological Workers Major Medium Medium jetting operations to be worn at all Slight Low Low
Disposal waste times.
Operations 2. All Hazardous waste to be
Mgr disposed of accordingly.
16-
• Operators 1. All personnel must be trained in the
Emergency Response (ENF) Spill
• Supervisors
response Laminated copies to be
• Poor Communication • Nearby
13. Emergency • No Knowledge Serious Medium High prominently displayed in work areas. Slight Low Low
of Emergency Workers 2. On site medic.
17- Adequate number of first aiders for
Operations operation.
Mgr

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

14- .Planning of the • No Coordination • Operator 1. Assess the operational area to identify
Task and • Unawareness of hazards and implement mitigation
• Personnel in controls prior to start the operation.
Communication Hazards
• Hazardous Working work area 2. Ensure that all required permits are
Environment raised, signed and are in place.
• 3rd Party
• Lack of 3. Conduct pre-start TBT meeting with all
personnel involved personnel prior to start the
Communication
• Failure of operation, identifying hazards and
Equipment discuss control measures prior to
• No Permits (if non work.
routine) 4. Check all working equipment is in
• Inexperienced good condition prior to use, high
Workers pressure pump checks including
mechanical and safety devices to be
• Unable to react to a 3 B Medium 2 B Low
carried out prior (checklist on back 3
spill situation
pages in procedures)
5. Ensure all the equipment have valid
certification.
6. Establish means of communication.
7. Designated Supervisor/Foreman for
task.
8. Consider weather conditions during
planning stage, is the floor slippery,
does the rain appose new risks, sun.
9. Ensure all required PPE is available
and in good condition.
10. Ensure workers know the emergency
spill situation
16- Hazardous waste • Heavy metals and • Operator 1. A MSDS sheet should be obtained
disposal biological waste, before starting water jetting
• Personnel
• Dunnage operations to identify if hazardous
• Plastic waste. in work materials are present in the substrate
or coating being jetted, if applicable.
area 2. PPE and facilities suitable for the
4 B Medium 2 B Low
• 3rd Party hazardous materials known or
personnel suspected to be present for the
waste generated from water jetting
operations to be worn at all times.
3. All Hazardous waste to be disposed
of accordingly.
18- .Emergency • Poor • Operator 1. Communication means to be
Communication. available at all times (Mobile & VHF).
• Personnel
• No Knowledge of 2. All personnel must be trained in the
Emergency. in work Emergency Response (ENF)
3 B Medium Laminated copies to be prominently 2 B Low
area displayed in work areas.
• 3rd Party 3. On site medic.
personnel 4. Adequate number of first aiders for
operation.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

Recovery Plan
Key Task Description Responsible Person
Emergencies Base ERP Task Supervisor
End of task checks to ensure area is left in a safe
Post Job Clean Up Task Supervisor
condition
Equipment Returned to normal storage Task Supervisor

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

Approved for use

Initial Risk Rating Residual Risk Rating Assessor & Approver
Position Name Signature Date
Supervisor LOW LOW Supervisor (to review and sign)

HSSEQ MED MED LOW Supervisor, HSSEQ (both to review and sign)

Country Manager MED Supervisor, HSSEQ and Base Manager (to review and sign)
HIGH Hazard has not been controlled, job cannot proceed. Re-
HIGH
assess the risk and controls.

LIKELIHOOD OF OCCURENCE
LOW MEDIUM HIGH

Severity People Environment Asset Reputation Asset Never heard of it in

Heard of it industry
Has occurred in
Happens Several Happens Several
but has not occurred Time a year in Times a year in this
industry Medserv
POTENTIAL CONSEQUENCE

in Medserv Medserv Location

A B C D E
Limited environmental impact. Spill Negligible damage
Slight First Aid
contained on site. (>$ 5,000)
Complaints by staff on site 1
Minor site building
Minor environmental impact.
damage (<$100,000). No Complaints by
Minor Medical Aid Reportable incident. No permanent
restricted access. locals/individuals 2 LOW
effect (<100 bbl).
Negligible recovery time
Local damage
Moderate environmental impacts.
(>$100,000 <$500,000)
Extends beyond site boundary.
Partial Site Shutdown.
Major Lost Time Injury Repeated exceedance of statutory or
Limited access
Local media story 3 MEDIUM
prescribed limit. (>100 bbl - <1000
restrictions. Recovery
bbl).
time: 1-3 days.
Major damage (>$500,00
Serious medium term environmental <$5,000,000) Site
impacts. Extended exceedance of shutdown. Substantial
Serious Permanent Injury
statutory or prescribed limit. access limitations.
National media story 4 HIGH
(<10,000 bbl). Recovery time: < 10
days.
Essential damage
Severe environmental damage. (>$5,000,000) 100% site
Catastrophic Fatality Extends over large area. (>10,000 shutdown. Access International media story 5
bbl). prohibited. Recovery
time: > 10 days.

Focus recourses in other higher Identify additional controls & Identify additional controls &
Low Significance risk areas, manage for continuous Medium Significance recovery measures & implement if High Significance recovery measures & implement.
improvement. practicable.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

Approved for use

Initial Risk Rating Residual Risk Rating Assessor & Approver
Position Name Signature Date
Supervisor LOW LOW Supervisor (to review and sign)

HSSEQ Ramy Shadad 20/12/22 MED MED LOW Supervisor, HSSEQ (both to review and sign)

Country Manager Daniel Wright 20/12/22 MED Supervisor, HSSEQ and Base Manager (to review and sign)
HIGH Hazard has not been controlled, job cannot proceed. Re-
HIGH
assess the risk and controls.

LIKELIHOOD OF OCCURENCE
LOW MEDIUM HIGH

Severity People Environment Asset Reputation Asset Never heard of it in

Heard of it industry
Has occurred in
Happens Several Happens Several
but has not occurred Time a year in Times a year in this
industry Medserv
POTENTIAL CONSEQUENCE

in Medserv Medserv Location

A B C D E
Limited environmental impact. Spill Negligible damage
Slight First Aid
contained on site. (>$ 5,000)
Complaints by staff on site 1
Minor site building
Minor environmental impact.
damage (<$100,000). No Complaints by
Minor Medical Aid Reportable incident. No permanent
restricted access. locals/individuals 2 LOW
effect (<100 bbl).
Negligible recovery time
Local damage
Moderate environmental impacts.
(>$100,000 <$500,000)
Extends beyond site boundary.
Partial Site Shutdown.
Major Lost Time Injury Repeated exceedance of statutory or
Limited access
Local media story 3 MEDIUM
prescribed limit. (>100 bbl - <1000
restrictions. Recovery
bbl).
time: 1-3 days.
Major damage (>$500,00
Serious medium term environmental <$5,000,000) Site
impacts. Extended exceedance of shutdown. Substantial
Serious Permanent Injury
statutory or prescribed limit. access limitations.
National media story 4 HIGH
(<10,000 bbl). Recovery time: < 10
days.
Essential damage
Severe environmental damage. (>$5,000,000) 100% site
Catastrophic Fatality Extends over large area. (>10,000 shutdown. Access International media story 5
bbl). prohibited. Recovery
time: > 10 days.

Focus recourses in other higher Identify additional controls & Identify additional controls &
Low Significance risk areas, manage for continuous Medium Significance recovery measures & implement if High Significance recovery measures & implement.
improvement. practicable.

Approved for use Initial Risk Rating Residual Risk Rating Assessor & Approver

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

Position Name Signature Date

Supervisor LOW LOW Supervisor (to review and sign)

HSSEQ Ramy Shadad 20/12/2022 MED MED LOW Supervisor, HSSEQ (both to review and sign)

Country Manager Daniel Wright 20/12/2022 MED Supervisor, HSSEQ and Base Manager (to review and sign)
HIGH Hazard has not been controlled, job cannot proceed. Re-
HIGH
assess the risk and controls.

LIKELIHOOD OF OCCURENCE
LOW MEDIUM HIGH

Severity People Environment Asset Reputation Asset Never heard of it in

Heard of it industry
Has occurred in
Happens Several Happens Several
but has not occurred Time a year in Times a year in this
industry Medserv
POTENTIAL CONSEQUENCE

in Medserv Medserv Location

A B C D E
Limited environmental impact. Spill Negligible damage
Slight First Aid
contained on site. (>$ 5,000)
Complaints by staff on site 1
Minor site building
Minor environmental impact.
damage (<$100,000). No Complaints by
Minor Medical Aid Reportable incident. No permanent
restricted access. locals/individuals 2 LOW
effect (<100 bbl).
Negligible recovery time
Local damage
Moderate environmental impacts.
(>$100,000 <$500,000)
Extends beyond site boundary.
Partial Site Shutdown.
Major Lost Time Injury Repeated exceedance of statutory or
Limited access
Local media story 3 MEDIUM
prescribed limit. (>100 bbl - <1000
restrictions. Recovery
bbl).
time: 1-3 days.
Major damage (>$500,00
Serious medium term environmental <$5,000,000) Site
impacts. Extended exceedance of shutdown. Substantial
Serious Permanent Injury
statutory or prescribed limit. access limitations.
National media story 4 HIGH
(<10,000 bbl). Recovery time: < 10
days.
Essential damage
Severe environmental damage. (>$5,000,000) 100% site
Catastrophic Fatality Extends over large area. (>10,000 shutdown. Access International media story 5
bbl). prohibited. Recovery
time: > 10 days.

Focus recourses in other higher Identify additional controls & Identify additional controls &
Low Significance risk areas, manage for continuous Medium Significance recovery measures & implement if High Significance recovery measures & implement.
improvement. practicable.

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 Medserv Egypt
Task Based Risk Assessment

Date: 08/01/24

Name Signature Date

By signing below, I confirm that this TBRA has been communicated to me including identification of activity hazards and the controls in place. I also confirm that I
will follow the controls identified within this TBRA and STOP THE JOB if anyone deviates from the controls or other factors impact on the effectiveness of the
controls.

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