Mosaik Aerial Music Video

SHOOT DATE/S: 3.11.15

LOCATION THIS FORM RELATES TO: Easton

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

Severity

Likelihood

Risk Factor

Yes

Yes

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

LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE:

Hazard no: 4
Description

Risk Factor (1-5)

2
I will be using a large tripod and a small camera stabilizer with my camera mounted
on top

Person(s) exposed (detail if

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

People exposed to: Director, assisting crew

Equipment will be carried and moved with care, with any external wiring being taped
down to the equipment and made to stand out with red tape

Person/company responsible Director

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

Risk removed? (y/n)

Hazard no:8
Description

Risk Factor (1-5)

3
There will be a lot of walking in Easton, the crew will be helping to carry slightly
heavy equipment

Person(s) exposed (detail if

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

People exposed to: Director, assisting crew

Regular rest breaks and I will ask if all of the crew are okay to continue with filming

Person/company responsible Director

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: 15
Description

Risk Factor (1-5)

2
I will be filming in Easton at night walking around to find different places to film
footage

Person(s) exposed (detail if

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

People exposed: Director, assisting crew

There will be more focus put into where we are walking and torches will be used to
light the way

Person/company responsible Director

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: 27
Description

Risk Factor (1-5)

3
There are a few roads around Easton with various vehicles driving along them

Person(s) exposed (detail if

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

People exposed: Director, assisting crew

All crew will be kept off the road by a chosen over watcher, and for the camera
operator a person will stand behind so they do not move into the road

Person/company responsible Assisting crew member

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

Jonathan Eley

Position: Director/Producer
Date: 27.10.15

Risk removed? (y/n)