HSE name Incident Investigation Main contractor LTI Date

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes HSE Investigation template and guidance LTI, Hi. Po and HVL Incident Lost Time Incident - High Potential – High Value Learning Confidential - Not to be shared outside of PDO/PDO contractors

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes Process flow for investigations Notification Quality sign off IRC/MDIRC Kick off MSE 3 IRC Minutes Investigation Reporting draft PIM action close out Confidential - Not to be shared outside of PDO/PDO contractors

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes Incident Investigation Terms of Reference (To. R) Info to be established during Kick Off meeting Remember guidance notes on bottom of slides Investigation protocols - Documents to be used to investigation PR 1418 Incident Owner - Name and reference indicator PIM No - XXXXXX Investigation Team Leader - Names, reference indicators, role in investigation Special terms - Special conditions/requirements of the investigation (e. g. joint PDO/contractor) Subject Matter Experts – as required to be discussed during Kick Off meeting Investigation deliverable - The team is responsible for investigating the incident and completing the following: Investigation report , MD/IRC presentation and learning pack. Dates to be adhered to - Incident owner to book directorate IRC in line with time line Previous LTI / NAD / Asset Integrity - Previous incident, similar incident, including PIM No from company Immediate Cause – Bring to kick off meeting for agreement Critical Factors – 1. 2. Investigation Team Members- Names, reference indicators or job title, role in investigation Note: Contractors should lead their own investigations, not PDO 1. Investigation Team lead Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) 2. Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) 3. Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) If not HII (ICAM) trained the contractor is to provide Incident investigator, level of competency assurance from senior management Evidence repository must be provided electronically on data stick prior to MSE 3 IRC Confidential - Not to be shared outside of PDO/PDO contractors

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes Timetable to be communicated during kick off meeting • Incident classification, Critical factors, SME requirements, Timelines for reports Rolling Days Action / Task 0 0 -1 1 10* 21 23* 30* 42 Notification received from MCOH Initial Notification, and first Alert Kickoff meeting 1 st Draft of report to MSE 3 team - Review 1 st draft return consolidated feedback 2 nd Draft of report to MSE 3 team - Review of 2 nd draft return consolidated feedback Final revision for MSE IRC MSE 3 IRC Final report - MSE 3 to complete QA/QC letter Director IRC MDIRC * Escalation process milestones for not keeping to the timeline: +3 days over due reminder 1 to Investigation Team Leader, HSE Team Leader and MSE 3 +5 days over due reminder 2 to Investigation team lead, HSE Team leader, MSE 3, MSEM and Director Confidential - Not to be shared outside of PDO/PDO contractors

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Singular photograph of the incident: (MDIRC only) Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI date of incident. Main contractor name – LTI# - Date of No), incident slides Bulleted description key points from the incident (MDIRC only) • Insert key findings maximum 5 bullet points (high level) Confidential - Not to be shared outside of PDO/PDO contractors header on all

Main Contractor Name, Incident LTI of No), date of incident. Main contractor name –Type LTI# (eg. - Date incident header on all slides Incident details PDO directorate/dept : (e. g. OSD /OSO) Contractor name/number: (subcontractor-PDO)/CXXXXXX Incident owner : Name / Ref Ind Location : Area / unit - (road/yard/station/rig/hoist/plant etc) Incident date & time : Incident type : (d/m/yr) / (24 hour clock) – advise if estimated Fatal, LTI, high potential, significant incident etc Actual severity rating : Number (1 -5) / letter (P, E, A, R) – from RAM Potential risk rating Letter (A-E), Number (1 -5)/letter (P, E, A, R) from RAM : Names of any IPs : Names of the injured people (for fatality add marital status with kids age and sex) Description of injury/damage: PIM ID : Immediate cause : Worst injuries (fractures, head injury, amputation etc)/damage, body part Number assigned in PIM Short description of what caused harm Key mgmt system failure: Key Management system failure from conclusion slide including number Previous LTI (PIM No. ) : (LTI/Hi. Po) of the contractor, this applicable to all contracts with PDO and not specified to a specific contract No. Confidential - Not to be shared outside of PDO/PDO contractors

Main Contractor Name, Incident Type (eg. LTI#00), date of incident- header on all Main contractor name – LTI# - Date of incident slides Description of the incident: (Read the guidance in foot notes of each slide) Confidential - Not to be shared outside of PDO/PDO contractors

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Photographs, diagrams & sketches: Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Sequence of events/timeline: No. Date Time Description of event 1 2 3 4 5 6 7 8 Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Critical Factors: 1. 2. 3. Critical Factor 1, Critical Factor 2, Critical Factor 3, Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Key Causational Factors: 1. Critical factor 1 Causational factor 1: Causational factor 2: Causational factor 3: 2. Critical factor 2 Causational factor 1: Causational factor 2: Causational factor 3: 3. Critical factor 3 Causational factor 1: Causational factor 2: Causational factor 3: Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Findings: Immediate causes: Unsafe actions: Immediate ICAM Causation description Cause Ref No # Justification for causation cited Unsafe conditions: Immediate Cause Ref No # ICAM Causation description Justification for causation cited Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Findings: Underlying causes (human and workplace): IC Ref No# UC Ref No# ICAM Causation Description Justification for causation cited Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident header on all slides Findings: management system failures (MSF) UC Ref No # MSF Ref No # ICAM Management Failure Justification for management system failure cited Description Confidential - Not to be shared outside of PDO/PDO contractors

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident Life Saving Rules Were life saving rule breaches related to the incident? - Yes / No? Who broke them? Names/Ref Inds: …………………. ……. . Which rule (s): Did the life saving rule breach, cause it? - Yes / No? Why……………………. . ……………………………… Delete which is not applicable Is consequence management in PIM actions Yes / No ? PIM action number: If a contractor broke the rule has the Contract Holder been informed of the action taken? Yes / No ? Confidential - Not to be shared outside of PDO/PDO contractors header on all slides

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident header on all slides PDO Contract management to be completed and confirmed by the contract holder Report on the state of the contract management and whether any omissions were causational No Contract management process Evidenced Y/N 1 HEMP signed off by Contract Holder 2 Annual HSE plan approved and tracked by Contract Holder 3 Monthly HSE meetings held with Contract Holder and actions recorded 4 Tracking register for close out of HSE actions in place 5 HSE audits, inspections , site visits conducted as per plan 6 HSE competency assured in review of HSE training matrix (Include % completed) 7 HSE VTCs implemented correctly 8 HSE procedural step-outs managed effectively 9 Evidence of MOC being effectively managed by Contract Holder 10 Evidence of HSE defaults for non compliances Confidential - Not to be shared outside of PDO/PDO contractors Causational Y/N Comments

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident header on all slides Immediate actions taken: Actions taken 1 Date Review HEMP for appropriateness in regards to the incident, is it used, how is it translated into action, last review date and what changes have been made. 2 3 4 5 *Immediate actions must be completed within 7 days of the incident Confidential - Not to be shared outside of PDO/PDO contractors Action party PDO / contractor Status

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident header on all slides Remedial actions planned: Remedial actions planned 1 MSF Causation number Target date Contracto PDO action r action party for party PIM Action party accepted Yes / No Mandatory action: If LSR is identified it must be flagged in PIM as LSR 2 3 4 5 6 7 Confidential - Not to be shared outside of PDO/PDO contractors PIM action No. Status Open / Closed Post action verifier for PIM

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident header on all slides Recommendations for MDIRC/IRC endorsement: Recommendation No 01 Status Endorsed/Not endorsed Causations No Recommendation . Action party Reference Ind. Target date Revised recommendation after IRC review Recommendation No 02 Status Causations No Recommendation Action party Reference Ind. Target date Revised recommendation after IRC review Confidential - Not to be shared outside of PDO/PDO contractors Endorsed/Not endorsed

Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Main contractor name – LTI# - Date of incident Incident Review Committee Contractor Commitment Declaration I, Mr. …………………. CEO, and I, Mr. ………………………. Operations Manager Of the Company: …………………. We have signed below to demonstrate to PDO our commitment to personally conduct the necessary follow up to ensure the effective implementation of the agreed actions contained in the IRC endorsed investigation in all our units, and to demonstrate our personal leadership in implementing the necessary consequence management in case of re-occurring of similar incident. Moreover, we will disseminate the learning from this incident to all our workforce and our subcontractors. Mr. …………………… Signature: ………………………… Date: ………………. . Confidential - Not to be shared outside of PDO/PDO contractors

PDO Second Alert Main contractor name – LTI# - Date of incident Date: Incident title What happened? Short description of what happened Photo explaining what was done wrong Your learning from this incident. . (This must solely relate to the people at risk of harm or people at risk of causing the harm) • Learning points for them from the investigation Strap line – should be the key (keep short and memorable ) Photo explaining how it should be done right Confidential - Not to be shared outside of PDO/PDO contractors

Management self audit Main contractor name – LTI# - Date of incident Date: Incident title As a learning from this incident and ensure continual improvement all contract managers must review their HSE HEMP against the questions asked below Confirm the following: 1. 2. 3. 4. 5. 1 2 3 4 5 * If the answer is NO to any of the above questions please ensure you take action to correct this finding. Confidential - Not to be shared outside of PDO/PDO contractors

Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Main contractor name – LTI# - Date of incident Date held: Directorate or MD IRC Minutes: Directorate/dept: Identity of minute taker: Name/Ref Ind: Item No Action party Target date 1 2 3 4 5 6 7 Confidential - Not to be shared outside of PDO/PDO contractors

Main Contractor Name, Incident Type (eg. LTI), date of incident. Main contractor name – LTI# - Date of incident header on all slides Supplementary investigation findings: The findings are points to note but were not causational in the incident 1. 2. 3. 4. 5. 6. 7. Non causational findings to the incident but worth to address Did you identify something important that is worthy of note Emergency response, how effective was it, did it impact on the severity? People, training, age, experience, nationality, medical conditions, disciplinary record etc should be in the form of a table with dates completed Equipment, type, serial number, maintenance, inspection, failings, appropriate for use etc should be in the form of a table with dates completed Operational management , sub contractor management, supervision, TBTs, SJPs, SWPs, STOP, availability on site etc Relevant environment, workplace conditions, weather, lighting, floor surface, dust, cramped etc Previous relevant incidents/ learning‘s what, where, were they aware of it, were controls introduced Confidential - Not to be shared outside of PDO/PDO contractors

Main contractor name – LTI# - Date of incident Investigation Team Members- Names, reference indicators, role in investigation Name 1 2 3 4 5 6 7 8 9 10 Ref. Ind Role Attended the scene Yes / No Investigation Team Lead *HII – HSE Incident Investigation Confidential - Not to be shared outside of PDO/PDO contractors HII* trained Yes / No Date attended HII training