Edmonton Risk Assessment Form

RISK ASSESSMENT FORM
Shoot date 17/10/15		Production Title             Jealous type		Producer  Sumaya

                                                                               

Location: Edmonton
Address: Streamside Cl, London, England N9

RATINGS:

·          each risks severity on scale from Negligable1 (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)

·         risk factor from the table overleaf.

Hazard		Present?	Severity	Likelihood	Risk Factor
1	Alcohol/drugs	n	L	VU	3
2	Animals/insects	n	L	VU	3
3	Audiences	n	L	VU	3
4	Camera cable/grip equipment	N	L	VU	3
5	Confined spaces	n	L	VU	3
6	Derelict buildings/dangerous structures	n	L	VU	3
7	Electricity/gas (other than normal supplies)	n	L	VU	3
8	Fatigue/long hours	y	M	VU	3
9	Fire/flammable materials	n	L	VU	3
10	Hazardous substances	n	L	VU	3
11	Heat/Cold/extreme weather	n	L	VU	3
12	Laser/strobe effects	n	L	VU	3
13	Machinery/industrial/ crane/hoist	N	L	VU	3
14	Materials - glass, non-fire retardant set materials	n	L	VU	3
15	Night operation	n	L	VU	3
16	Noise – high sound levels	n	L	VU	3
17	Non standard manual handling	n	L	VU	3
18	Public/crowds	n	L	VU	3
19	Radiation	n	L	VU	3
20	Scaffold/Rostra	n	L	VU	3
21	Smoking on set	n	L	VU	3
22	Special effects/explosives	n	L	VU	3
23	Special needs (elderly, disabled, inexperienced)	n	L	VU	3
24	Specialised rescue/first aid	n	L	VU	3
25	Stunts, dangerous activities	n	L	VU	3
26	Tall scenery/suspended ceilings	n	L	VU	3
27	Vehicles/speed	n	L	VU	3
28	Water/proximity to water	n	L	VU	3
29	Weapons	n	L	VU	3
30	Working at heights	n	L	VU	3
31	Working overseas	n	L	VU	3
32	Other risks	n	L	VU	3

Calculate the Risk Factor:

	Very Unlikely	Unlikely	Possible	Likely	Very Likely
Very severe	3	4	4	5	5
Severe	2	3	3	3	5
Moderate	2	2	3	3	3
Low	1	2	2	3	3
Negligible	1	1	2	2	3

Decide the action to take:

5	Very severe	Take immediate action
4	Severe	High priority
3	Moderate Risk	Programme for action
2	Low Risk	Action may be required
1	Negligible	Probably acceptable

Then list each risk identified

Hazard no: 8			Risk Factor (1-5):			1
Description	Fatigue/long hours – there is going to be unforeseen changes.
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Cast/crew
Action to take	Ensure that we stick to the storyboard and timings.
Person/company responsible for action	producer
To be completed at agreed later date
Exposed person(s) informed? (y/n)	y	Agreed action taken? (y/n)		y	Risk removed? (y/n)		Y

Completed by:  SARAH                                                   Position: MAIN ACTOR

Signature          SARAH                                                   Date: 05/10/2015