FORM RA 002 (adapted for Student Media Productions)

Equipment booking

Name of hirer Jaz Reader

Facility / equipment required

Catalogue Description Hours/days Unit Cost
code cost
DSLR 3 and a
half days
Tri-pod 3 and a
half days

Total

Date Time
Issue Thursday 6th December 4.00pm
Return Monday 10th December 9.10am

Please give as much notice as possible. Location filming requests MUST be submitted at least
48 hours in advance to ensure batteries can be charged etc.

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 FORM RA 002 (adapted for Student Media Productions)

Call sheet

Production title Teddy Bears

Call sheet for (date) Friday 7th December 2018

Production team
Names Roles Contact details
Jaz Camera + Director
Kieran Camera + Director
Kris Camera + Director
Actors
Maia Burgess Victim

First aider

Base address and contact details:

Location address:

Map attached.

Access info:

Contact details:

Travel arrangements:

Times
Meet time at base – Devizes Market place @ 3.00pm

On location – 3.15

Shoot time (s) and scene numbers – 2 hours

Planned breaks and catering arrangements – bring your own food/refreshments + one ten minute break

Projected wrap time – 5.15pm

Back at base time – 5.30

Weather report (if outside)

Clouds with sun and a bit of rain

Special considerations with regard to location/weather/activities etc

- Bring a teddy bear

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 FORM RA 002 (adapted for Student Media Productions)

RISK ASSESSMENT FOR LOCATION DATE OF

7.12.18
ACTIVITY
FILMING
TASK / ACTIVITY DATE
3.12.18
Filming Stalker Scene ASSESSED

BRIEF DESCRIPTION

Filming throughout Devizes at different stages of the night

See Risk Assessment Assistant (Page 3) for scoring.

RISK RATING
1
(likelihood × consequence = )
Include the risk ‘word’ (i.e. acceptable, adequate, tolerable, unacceptable).

PEOPLE NUMBER OF PEOPLE UNDERTAKING TASK 4

DURATION OF TASK 3 hours maximum

PERSONNEL PROFILE / TRAINING GIVEN

PERSONNEL INSTRUCTED PERSONNEL INSTRUCTED PERSONNEL INSTRUCTED

STAFF 0 TALENT 1 YOUNG PERSON 3

STUDENT 3 CONTRIBUTORS 4 VISITOR 0

PERSONNEL
PUBLIC 0 0
WORKING ALONE

SPECIALIST
DISABLED 0 TRAINED 0
PERSONNEL

CONTROL MEASURES IN PLACE (Guarding, Safe Systems of Work, PPE, etc)

Wear sturdy footwear so we don’t slip over. Also bring torches/use phone torches as it gets later on at night. We will be aware of the
public and not disrupt their own activities. We will also practice the small fighting scene before we shoot it so nothing goes wrong.

TO BE COMPLETED BY STAFF ASSESSOR(S) (Ctrl+Tab to add tab stops between columns)

EXTRA ACTIONS REQUIRED TO CONTROL SIGINIFICANT RISKS ACTIONED BY DATE

STUDENT ASSESSOR(S) Jaz Reader

STAFF ASSESSOR(S)

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 FORM RA 001
ACTIVITY / TASK
HAZARD IDENTIFICATION
HAZARD TYPE PRESENT HAZARD TYPE PRESENT
COMMENTS COMMENTS
1. Mechanical / Physical Hazards YES NO 4. Production Hazards YES NO

1.1 Slips / Trips / Falls Wet grass 4.1 Stressful Postures

1.2 Vehicles 4.2 Lifting / Handling

1.3 Camera Grip Equipment Tri-pod 4.3 Inadequate Breaks

1.4 Falling Equipment 4.4 Restricted Visibility (viewfinder) Dark light

1.x Other Mechanical Hazards 4.5 Camera Tracking/Crabbing

2. Electrical Hazards YES NO COMMENTS 4.6 Working at Height

2.1 Direct Contact 4.x Other Workplace Hazards

2.2 Indirect Contact 5. Hazardous Substances YES NO COMMENTS

2.3 Short Circuit / Overload 5.1 Explosive / Biological / Chemical

2.4 Source of Ignition 5.2 Substances in set construction

2.5 Proximity to Water 5.x Other Hazardous Substances

3. Production Activities YES NO 6. Environmental Hazards YES NO COMMENTS

3.1 Extreme Sports 6.1 Localised Hot / Cold Surfaces

3.2 Animals (working with or proximity to) 6.2 High / Low Ambient Temp.

3.3 Fight sequences Pretending to hit someone 6.3 Poor Lighting Night time

3.4 Potential Intervention from Public May be public walking in the street 6.4 Confined spaces

3.5 Potential for Assault 6.5 Poor Weather

3.6 Noise pollution 6.6 Uneven/Slippery Surfaces Wet grass

3.7 Smoking 6.7 Unsafe structures

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 FORM RA 001
3.8 Alcohol 6.8 Sharps & breakages

3.x Other Production Activity Hazards 6.x Other Environmental Hazards

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 FORM RA 001

RISK ASSESSMENT ASSISTANT

These are the basic terms that apply to a Risk Assessment:

A hazard is anything that has the potential to cause harm. This could be something as specialised as a piece of
complicated machinery, or as commonplace as a cup of coffee. If it could be harmful in any way, then it’s a
hazard.

A hazardous event takes place when someone or something interacts with the hazard and allows it to cause
harm. Take a hole in the ground for example. The hole (the hazard), by itself isn’t causing any harm, but if
someone tripped over it (the hazardous event) then it would become harmful. Every hazardous event has a
likelihood and a consequence.

Likelihood is a measure of the chance that the hazardous event will occur. If the hole is in a busy area, such as
a shop entrance, it’s more likely someone will trip over it. However if it’s in an area that doesn’t get a lot of traffic,
such as a back yard, tripping over it would be less likely.

The consequence is the outcome of the hazardous event. If you tripped over a hole, there could be several
possible outcomes; you might land on your feet with no damage at all, you might drop whatever you are carrying,
or perhaps you could end up with a sprained ankle or even a fracture.

Risk is the combination of the likelihood of a hazardous event occurring and the consequence of the event.

Risk = likelihood x consequence

Below is a table to help you work out the score for the likelihood and consequence. Once you have
done this, multiply the two numbers to get the Risk Rating.

Risk
Likelihood Consequence
Score
Very unlikely – might happen once in 5 years 1 No injury

Unlikely – would not happen in 2-3 years 2 Minor - minor injury requiring first aid

Fairly Likely – would expect to happen once a year 3 Moderate - up to three days’ absence

Likely – could occur 2-3 times a year 4 Major – more than three days’ absence

Very Likely – likely to happen 2-3 times a week 5 Catastrophic – Death or multiple deaths

Risk Matrix – this is used for estimating and evaluating the risk it is a commonly used tool. Usually the higher the
risk level, the more serious the risk and the more likely you’ll need to take action.

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 FORM RA 001

UNACCEPTABLE – Stop the activity and make

5 10 15immediate
20 improvements
25
17-25
 CONSEQUENCE 

4 8 12 16 20

3 6 9 TOLERABLE
12 15– look to improve within a specified
timescale 10-16
2 4 6 8 10

1 2 3 4 5
ADEQUATE – Look to improve at next review
 LIKELIHOOD 
5-9

1-5

If you are still not sure or just have a question, please do not hesitate in contacting the Health & Safety
Department – We are here to help!

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