Hollow Coves- The Woods

SHOOT DATE/S: 10/10/15-05/11/15

PRODUCTION OFFICE PHONE/MOBILE: 07881360176

LOCATION THIS FORM RELATES TO: (A separate form should be completed for each location)
15 The Swale, Threescore, Norwich NR5 9HE
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

7
8
9

Severity

Likelihood

Risk Factor

Yes
Yes

N
L

VU
P

1
2

Electricity/gas (other than normal supplies)

Fatigue/long hours
Fire/flammable materials

Yes

10
11

Hazardous substances
Heat/Cold/extreme weather

Yes

12
13

Laser/strobe effects
Machinery/industrial/ crane/hoist

14
15

Materials - glass, non-fire retardant set materials

Night operation

Yes

VU

16
17
18

Noise high sound levels

Non standard manual handling
Public/crowds

19
20

Radiation
Scaffold/Rostra

21
22

Smoking on set
Special effects/explosives

23
24
25

Special needs (elderly, disabled, inexperienced)

Specialised rescue/first aid
Stunts, dangerous activities

26
27

Tall scenery/suspended ceilings

Vehicles/speed

Yes

VU

28
29

Water/proximity to water
Weapons

30
31

Working at heights
Working overseas

32

Other risks

Unlikely

Possible

Likely

Very Likely

4
3
2
2
1

4
3
3
2
2

5
3
3
3
2

5
5
3
3
3

Calculate the Risk Factor:

Very Unlikely
Very severe
Severe
Moderate
Slight
Negligible

3
2
2
1
1

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

LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE:

Hazard no:
Description
Person(s) exposed (detail if
cast/crew (C), outside
company (O) or public (P) )
Action to take

Open Fire
Risk Factor (1-5)
3
A fire will be created within a pit (Silver Bin) but will not be touchable as the flames
will only be coming out at a height from the top of the bin. Will only be alight for a
short amount of time, 1-2 hours.
C- 10 people will be exposed to the fire.
O
Put tape on floor representing how close the crew are allowed to the fire.

Person/company responsible Me, Charlotte Johnston.

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

Risk removed? (y/n)

Hazard no:
Description

Cables on Floor.
Risk Factor (1-5)
2
I will need to place lights outside to emphasise the light from the fire as I am
shooting within in dark so will have cables on the floor which could be a trip hazard.

Person(s) exposed (detail if

cast/crew (C), outside
company (O) or public (P) )
Action to take

C- 10 people will be made aware of the wires.

O
Place tape on the cables so they are easier to manoeuvre.

Person/company responsible Me, Charlotte Johnston

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

Hazard no:
Description

Night Operation.
Risk Factor (1-5)
I will be filming at night so lighting will be limited.

Person(s) exposed (detail if

cast/crew (C), outside
company (O) or public (P) )
Action to take

C- 10 people will be outside while Im filming.

O

Risk removed? (y/n)

Create more light by having torches and light boxes surrounding the garden.

Person/company responsible Me, Charlotte Johnston

for action
To be completed at agreed later date Exposed person(s)
Y
Agreed action taken? (y/n)
Y
Risk removed? (y/n)
Y
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: Charlotte Johnston

Position: Director

Signature

Date: 05/10/15

Countersigned by:

PRODUCER

Signature

Date: