1. Risk Assessment Form โ Part A
ProductionName: Curtis Oldroyd Organisation
ProductionAddress: 1b Bridge Lane
Wimblington
Producer / Editor
Tel:
Mobile:
Start date 30/09/16 End date
Distribution
Who gets a copyof the assessment
Mr Hibbert
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
Creating a horror film trailer
Team members / experts /
contractors / contributors etc.
List those involved
Curtis Oldroyd, Luke Green, Brett Liddy,
Locations
Outline locationsinvolved โ indicate
any which are hostile environments
Bridge Lane
Assessor Name
Signature
Date completed
Authoriser Name
(if not Assessor) Signature
Date authorised
Hazard list โ select your hazards from the list belowand use these to complete Part B
Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick
Assault by person N Contact with cold liquid / v apour N Disease causativ e agent N
Attack by animal N Contact with cold surf ace N Inf ection N
Breathing compressed gas N Contact with hot liquid / v apour N Allergic reaction N
Cold env ironment Y Contact with hot surf ace N Lack of f ood / water N
Crush by load N Electric shock N Lack of oxy gen N
Drowning N Explosiv e blast N Phy sical f atigue N
Entanglement in mov ing machinery N Explosiv e release of stored pressure N Repetitiv e action N
High atmospheric pressure N Fire Y Static body posture N
Hot env ironment N Hazardous substance N Stress / anxiety N
Manual handling N Ionizing radiation N Venom poisoning N
Object f alling, mov ing or f ly ing N Laser light N
Obstruction / exposed f eature N Lightning strike N Environmental hazards
Sharp object / material Y Noise N Litter N
Shot by f irearm N Non-ionizing radiation N Nuisance noise / v ibration N
Slippery surf ace N Stroboscopic light N Phy sical damage N
Trap in mov ing machinery N Vibration N Waste substance released into air N
Trip hazard N Waste substance released into soil / water N
Vehicle impact / collision N Managerial / organisational hazards
Falls f rom height N Management f actors (lack of communication,
co-operation, co-ordination and competence)
N
Risk matrix โ use this to determine risk for
each hazard i.e. โhow bad and how likelyโ Likelihood of Harm
Severity of Harm
Remote
e.g. <1 in 1000 chance
Very unlikely
e.g. 1 in 200 chance
Unlikely
e.g. 1 in 50 chance
Possible
e.g. 1 in 10 chance
Likely
e.g. >1 in 3 chance
Negligible e.g. small bruise Trivial Trivial Trivial Low Low
Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium
Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High
Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high
Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
2. Risk Assessment Form โ Part B
Activity1
โ Each individual activity you are proposing: Location โ w here this activity willtake place: Dates / times:
Hazards2
List what could cause harm f rom this activ ity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
f rom this activ ity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
lev el of risk as if y ou were to
do the activ ity without y our
controls
Control measures
For each hazard, list the measures y ou will be taking to minimise the risk identif ied
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide lev el of risk
once all y our controls
are in place
Air Rifle ( NOT LOADED) Anyone in the proximity Medium Will take a photo of the air rifle that is not loaded, the barrelw illbe checked thoroughly Low
Knife Anyone in close
proximity
Medium Ensure the knife is held responsibility, ensuring that anyone that holds it understands to be
sensible
Low
Overgrown field Anyone w alking on it as
the ground may not
Low Try to only film on ground that is visible Low
Abandoned house Actors and cameraman Low Ensure that w e understand our surroundings and do not be silly w hen in the setting Low
Continue on separate sheet if necessary
1 โ complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A