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PRODUCTION TITLE: Oyster Travel Promotional Video PRODUCTION OFFICE PHONE/MOBILE: 07824325069 LOCATION THIS FORM RELATES TOO Old Catton, Norwich
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 below. Hazard 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Alcohol/drugs Animals/insects Audiences Camera cable/grip equipment Confined spaces Derelict buildings/dangerous structures Electricity/gas (other than normal supplies) Fatigue/long hours Fire/flammable materials Hazardous substances Heat/Cold/extreme weather Laser/strobe effects Machinery/industrial/ crane/hoist Materials - glass, non-fire retardant set materials Night operation Noise high sound levels Non standard manual handling Public/crowds Radiation Scaffold/Rostra Smoking on set Special effects/explosives Special needs (elderly, disabled, inexperienced) Specialised rescue/first aid Stunts, dangerous activities Tall scenery/suspended ceilings Vehicles/speed Water/proximity to water Weapons Working at heights Working overseas Other risks Present? Severity Likelihood Risk Factor
Decide the action to take: 5 Very severe 4 Severe 3 Moderate Risk 2 Low Risk 1 Negligible
Take immediate action High priority Programme for action Action may be required Probably acceptable
Hazard no: Description 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) informed? (y/n)
Hazard no: Description 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) informed? (y/n) Hazard no: Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take Risk Factor (1-5)
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: Tara Clements Signature Position: Date: 15/03/13