1. RISK
ASSESSMENT FORM
• NAME OF PRODUCTION:
• Production number : 1
• Production office telephone: 01642 288000
• Shoot dates: 23/11/16
• List of location(s), form relates to:
Tattoo Studio, Thornley
CCAD Film Studio
• Production manager name and mobile number;
Lydia Marley-Lawson
07581714097
• 1st AD name and mobile;
Danny Price
075838468408
• (exec) Producer name and mobile.
Daniel O’Brien
Complete the following table rating
• each risks severity on scale from Negligable (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 P
r
e
s
e
nt
?
S
e
v
e
r
i
t
y
L
i
k
e
l
i
h
o
o
d
Ris
k
Fa
cto
r
1 Alcohol/drugs N N VU
2 Animals/insects N N VU
3 Audiences N N VU
2. 4 Camera cable/grip equipment Y M L 3
5 Confined spaces N N VU
6 Derelict buildings/dangerous structures N N VU
7 Electricity/gas (other than normal supplies) Y M VL 3
8 Fatigue/long hours N N VU
9 Fire/flammable materials N N VU
10 Hazardous substances N N VU
11 Heat/Cold/extreme weather N N VU
12 Laser/strobe effects N N VU
13 Machinery/industrial/ crane/hoist N N VU
14 Materials - glass, non-fire retardant set materials N N VU
15 Night operation N N VU
16 Noise – high sound levels Y L L 3
17 Non standard manual handling N N VU
18 Public/crowds N N VU
19 Radiation N N VU
20 Scaffold/Rostra N N VU
21 Smoking on set N N VU
22 Special effects/explosives N N VU
23 Special needs (elderly, disabled, inexperienced) N N VU
24 Specialised rescue/first aid N N VU
25 Stunts, dangerous activities N N VU
26 Tall scenery/suspended ceilings N N VU
27 Vehicles/speed N N VU
28 Water/proximity to water Y M L 3
29 Weapons N N VU
30 Working at heights N N VU
3. 31 Working overseas N N VU
32 Other risks N N VU
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
Low risk 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
Then list each risk identified
Hazard no: 4 Cables Risk Factor (1-5) 3
Description Due to the fact that we will be using cables with the
camera and boom mic I believe that it could be a potential
tripping hazard.
4. Person(s) exposed
(detail if cast/crew
(C), outside
company (O) or
public (P) )
C
Action to take In order to prevent any risks I will ensure that all cables
are securely taped to the floor with gaffa tape. I will also
alert the crew and Rachel, the tattooist that there will be
cables on the floor as an extra precaution.
Person/company
responsible for
action
Lydia Marley-Lawson (Director)
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
Agreed action taken?
(y/n)
Risk removed?
(y/n)
Hazard no: 16 Noise Risk Factor (1-5) 3
Description In terms of noise the only noise which may cause a risk is
the sound of the tattoo gun which is a tedious buzzing
sound. Though this wont cause any harm to the cast and
crew it will become quite annoying during the hour shoot.
Person(s) exposed
(detail if cast/crew
(C), outside
company (O) or
public (P) )
C
Action to take I will allow a series of brief breaks from the tattooing and
allow cast and crew to leave the room during these
breaks.
Person/company
responsible for
action
Lydia Marley-Lawson (Director)
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
Agreed action taken?
(y/n)
Risk removed?
(y/n)
5. Hazard no: 7 Electricity and Gas Risk Factor (1-5) 3
Description Given the fact that we will be shooting in a tattoo studio
there will be electricity from lights and lamps to the
tattooist’s equiptment. For this reason I will take extra
precaution to keep any liquids away from the equipment
and electrical sources.
Person(s) exposed
(detail if cast/crew
(C), outside
company (O) or
public (P) )
C
Action to take By doing this I will be asking cast and crew to not eat or
drink during the shoot and advise the tattooist to keep all
of her cleaning products on the desk which will be a good
distance from the equipment.
Person/company
responsible for
action
Lydia Marley-Lawson (Director)
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
Agreed action taken?
(y/n)
Risk removed?
(y/n)
Hazard no: 28 Water Risk Factor (1-5) 3
Description The tattoo studio has certain health and safety
regulations which means that there is a sink and water
facilities to keep the work place hygienic.
Person(s) exposed
(detail if cast/crew
(C), outside
company (O) or
public (P) )
C
Action to take All electrical equipment will be kept at a safe distance
from the water sources and this will reduce the risk of
spillage which could cause cast or crew to slip as well as
protecting the equipment.
6. Person/company
responsible for
action
Lydia Marley-Lawson (Director)
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
Agreed action taken?
(y/n)
Risk removed?
(y/n)
Completed by: Lydia Marley-Lawson Position: Director
Signature Date: 20/11/16
Countersigned by: Danny Price PRODUCER
Signature Date: 21/11/16
Countersigned by: Mike Boyle Lecturer
Signature Date: 21/11/16