Page 1

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?

1 2

Alcohol/drugs Animals/insects

3 4

Audiences Camera cable/grip equipment

5 6

Confined spaces Derelict buildings/dangerous structures

N N

7 8 9

Electricity/gas (other than normal supplies) Fatigue/long hours Fire/flammable materials

Y N N

10 11

Hazardous substances Heat/Cold/extreme weather

N N

12 13

Laser/strobe effects Machinery/industrial/ crane/hoist

N N

14 15

Materials - glass, non-fire retardant set materials Night operation

N N

16 17 18

Noise – high sound levels Non standard manual handling Public/crowds

N N N

19 20

Radiation Scaffold/Rostra

N N

21 22

Smoking on set Special effects/explosives

N N

23 24 25

Special needs (elderly, disabled, inexperienced) Specialised rescue/first aid Stunts, dangerous activities

N N N

26 27

Tall scenery/suspended ceilings Vehicles/speed

N N

28 29

Water/proximity to water Weapons

N N

30 31

Working at heights Working overseas

N N

32

Other risks

Y

Severity

Likelihood

N N Maybe Y

Calculate the Risk Factor: Very severe Severe Moderate Slight Negligible

Very Unlikely

Unlikely

Possible

Likely

Very Likely

3 2 2 1 1

4 3 2 2 1

4 3 3 2 2

5 3 3 3 2

5 5 3 3 3

Decide the action to take: 5 Very severe 4 Severe 3 Moderate Risk 2 Low Risk 1 Negligible

Then list each risk identified

Take immediate action High priority Programme for action Action may be required Probably acceptable

Risk Factor

LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE:


Hazard no: 4 Description

Risk Factor (1-5) There will be 3 or 4 cameras so may be lots of wires

Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

C

2

Be careful, look where you’re going, maybe use signs

Person/company responsible Myself for action To be completed at agreed later date Exposed person(s) Agreed action taken? (y/n) informed? (y/n)

Hazard no: 7 Description

Risk Factor (1-5) In a kitchen so there will be gas supply

Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

C

Risk removed? (y/n)

3

Ask someone who knows about the kitchen the precautions to take

Person/company responsible Myself for action To be completed at agreed later date Exposed person(s) Agreed action taken? (y/n) informed? (y/n)

Risk removed? (y/n)

Hazard no: 32 Description

Risk Factor (1-5) 3 In a kitchen and will be using the cooking equipment that I am not confident with so I could set fire to everything

Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

C Ask someone who knows and get them to teach you how to use the equipment safely

Person/company responsible Myself for action To be completed at agreed later date Exposed person(s) Agreed action taken? (y/n) Risk removed? (y/n) informed? (y/n) 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: Sophie Goss-Garnham Signature

Position: Producer

Countersigned by:

PRODUCER

Signature

Date: 29/04/2013

Date:

Risk assessment form  
Read more
Read more
Similar to
Popular now
Just for you