SHOOT DATE/S: TBA

PRODUCTION OFFICE PHONE/MOBILE:

LOCATION THIS FORM RELATES TO: (A separate form should be completed for each location) TV Studio, City College

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

Electricity/gas (other than normal supplies)

Fatigue/long hours
Fire/flammable materials

10
11

Hazardous substances
Heat/Cold/extreme weather

12
13

Laser/strobe effects
Machinery/industrial/ crane/hoist

14
15

Materials - glass, non-fire retardant set materials

Night operation

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

28
29

Water/proximity to water
Weapons

30
31

Working at heights
Working overseas

32

Other risks

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

Severity

Likelihood

Yes

Yes

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

Take immediate action

High priority
Programme for action
Action may be required
Probably acceptable

Risk Factor

LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE: Black Shuk One Too Many

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

4
Risk Factor (1-5)
3
Camera equipment and cables along the floor in the TV studio, possible tripping
hazard and potential for equipment breakages. Also overhead lighting could cause
an issue.
Cast the four members of Black Shuk
Crew Director, Shelby Redfern
Extra precaution made when walking around the TV Studio. Note all equipment that
could be hazardous before filming.

Person/company responsible Shelby Redfern

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:5
Description

Risk Factor (1-5)

1
TV studio is a confined space that could cause issues in the event of a fire (in terms
of escape routes).

Person(s) exposed (detail if

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

Cast four members of Black Shuk

Crew Director, Shelby
Technician
Point out emergency exits, make sure they are not blocked.

Person/company responsible Shelby, City College

for action
To be completed at agreed later date Exposed person(s)
Y
Agreed action taken? (y/n)
informed? (y/n)
Hazard no:
Description

Risk removed? (y/n)

Risk Factor (1-5)

Person(s) exposed (detail if

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

Position:

Signature

Date:

Countersigned by:

PRODUCER

Signature

Date: