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PRODUCTION TITLE: SHOOT DATE/S:
PRODUCTION OFFICE PHONE/MOBILE:
LOCATION THIS FORM RELATES TO: (A separate form should be completed for each location)
Complete the following table rating
 each risks severity on scale from Negligible (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V)
 each risks likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL)
 Determine the risk factor from the table overleaf.
Hazard Present? Severity Likelihood Risk Factor
1 Alcohol/drugs
2 Animals/insects
3 Audiences
4 Camera cable/grip equipment
5 Confined spaces
6 Derelict buildings/dangerous structures
7 Electricity/gas (other than normal supplies)
8 Fatigue/long hours
9 Fire/flammable materials
10 Hazardous substances
11 Heat/Cold/extreme weather Y M L 3
12 Laser/strobe effects
13 Machinery/industrial/ crane/hoist
14 Materials - glass, non-fire retardant set materials
15 Night operation
16 Noise – high sound levels
17 Non standard manual handling
18 Public/crowds Y L U 2
19 Radiation
20 Scaffold/Rostra
21 Smoking on set
22 Special effects/explosives
23 Special needs (elderly, disabled, inexperienced)
24 Specialised rescue/first aid
25 Stunts, dangerous activities
26 Tall scenery/suspended ceilings
27 Vehicles/speed Y L P 2
28 Water/proximity to water
29 Weapons
30 Working at heights
31 Working overseas
32 Other risks
Calculate the Risk Factor:
Very Unlikely Unlikely Possible Likely Very Likely
Very severe 3 4 4 5 5
Severe 2 3 3 3 5
Moderate 2 2 3 3 3
Slight 1 2 2 3 3
Negligible 1 1 2 2 3
Decide the action to take:
5 Very severe Take immediate action
4 Severe High priority
3 Moderate Risk Programme for action
2 Low Risk Action may be required
1 Negligible Probably acceptable
LOCATIONRISKASSESSMENTFORM
Then list each risk identified
Hazard no: 11 Heat/Cold/Weather Risk Factor (1-5) 3
Description Weather forecast for the day is cold, with cold winds developing later
Person(s) exposed (detail if
cast/crew (C), outside
company (O) or public (P) )
all
Action to take Finnish filming before cold winds develop after 17:00pm. Crew are advised to go
inside if they feel cold
Person/company responsible
for action
Anyone may opt to go inside if they feel too cold
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
Y Agreed action taken? (y/n) Y Risk removed? (y/n) Y
Hazard no: 18 Crowds Risk Factor (1-5) 2
Description Location is close to property exit site. A lot of people may be passing through in close
proximity during filming
Person(s) exposed (detail if
cast/crew (C), outside
company (O) or public (P) )
all
Action to take Wait for crowds to pass area
Person/company responsible
for action
Director
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
Y Agreed action taken? (y/n) Y Risk removed? (y/n) Y
Hazard no: 27 Vehicles/Speed Risk Factor (1-5) 2
Description Road running parallel to filming location. 5mph speed limit limits the risk factor
Person(s) exposed (detail if
cast/crew (C), outside
company (O) or public (P) )
All. Camera operator is closer to the road
Action to take Camera operator will wear a high visibility jacket
Person/company responsible
for action
Director
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
Y Agreed action taken? (y/n) Y Risk removed? (y/n) Y
Copy and paste this table for each of the hazards, then get the form signed. If the producer has not completed
the risk assessment, then they should countersign this form.
Completed by: Position: Director
Signature Jordan Swan Date: 21/10/13
Countersigned by: PRODUCER
Signature Date:

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Risk assessment form 1

  • 1. PRODUCTION TITLE: SHOOT DATE/S: PRODUCTION OFFICE PHONE/MOBILE: LOCATION THIS FORM RELATES TO: (A separate form should be completed for each location) Complete the following table rating  each risks severity on scale from Negligible (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V)  each risks likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL)  Determine the risk factor from the table overleaf. Hazard Present? Severity Likelihood Risk Factor 1 Alcohol/drugs 2 Animals/insects 3 Audiences 4 Camera cable/grip equipment 5 Confined spaces 6 Derelict buildings/dangerous structures 7 Electricity/gas (other than normal supplies) 8 Fatigue/long hours 9 Fire/flammable materials 10 Hazardous substances 11 Heat/Cold/extreme weather Y M L 3 12 Laser/strobe effects 13 Machinery/industrial/ crane/hoist 14 Materials - glass, non-fire retardant set materials 15 Night operation 16 Noise – high sound levels 17 Non standard manual handling 18 Public/crowds Y L U 2 19 Radiation 20 Scaffold/Rostra 21 Smoking on set 22 Special effects/explosives 23 Special needs (elderly, disabled, inexperienced) 24 Specialised rescue/first aid 25 Stunts, dangerous activities 26 Tall scenery/suspended ceilings 27 Vehicles/speed Y L P 2 28 Water/proximity to water 29 Weapons 30 Working at heights 31 Working overseas 32 Other risks Calculate the Risk Factor: Very Unlikely Unlikely Possible Likely Very Likely Very severe 3 4 4 5 5 Severe 2 3 3 3 5 Moderate 2 2 3 3 3 Slight 1 2 2 3 3 Negligible 1 1 2 2 3 Decide the action to take: 5 Very severe Take immediate action 4 Severe High priority 3 Moderate Risk Programme for action 2 Low Risk Action may be required 1 Negligible Probably acceptable LOCATIONRISKASSESSMENTFORM
  • 2. Then list each risk identified Hazard no: 11 Heat/Cold/Weather Risk Factor (1-5) 3 Description Weather forecast for the day is cold, with cold winds developing later Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) all Action to take Finnish filming before cold winds develop after 17:00pm. Crew are advised to go inside if they feel cold Person/company responsible for action Anyone may opt to go inside if they feel too cold To be completed at agreed later date - Exposed person(s) informed? (y/n) Y Agreed action taken? (y/n) Y Risk removed? (y/n) Y Hazard no: 18 Crowds Risk Factor (1-5) 2 Description Location is close to property exit site. A lot of people may be passing through in close proximity during filming Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) all Action to take Wait for crowds to pass area Person/company responsible for action Director To be completed at agreed later date - Exposed person(s) informed? (y/n) Y Agreed action taken? (y/n) Y Risk removed? (y/n) Y Hazard no: 27 Vehicles/Speed Risk Factor (1-5) 2 Description Road running parallel to filming location. 5mph speed limit limits the risk factor Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) All. Camera operator is closer to the road Action to take Camera operator will wear a high visibility jacket Person/company responsible for action Director To be completed at agreed later date - Exposed person(s) informed? (y/n) Y Agreed action taken? (y/n) Y Risk removed? (y/n) Y Copy and paste this table for each of the hazards, then get the form signed. If the producer has not completed the risk assessment, then they should countersign this form. Completed by: Position: Director Signature Jordan Swan Date: 21/10/13 Countersigned by: PRODUCER Signature Date: