Dapa Deep Mine video shooting

SHOOT DATE/S: 25-26/10/2015

PRODUCTION OFFICE PHONE/MOBILE: 07539550751

LOCATION THIS FORM RELATES TO: The prison hill

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?

Severity

Likelihood

Risk Factor

1
2

Alcohol/drugs
Animals/insects

yes

3
4

Audiences
Camera cable/grip equipment

yes
yes

M
N

P
VU

3
1

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

yes

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

yes

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

yes

32

Other risks

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

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

Take immediate action

High priority
Programme for action
Action may be required
Probably acceptable

LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE:

Hazard no:2
Description

Risk Factor (1-5)

Working outside, might be birds and insects.

Person(s) exposed (detail if

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

Have an insect spray

Person/company responsible Myself

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

Risk removed? (y/n)

Hazard no:3
Description

Risk Factor (1-5)

3
It is a public place, audiences might be present as other people.

Person(s) exposed (detail if

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

C, O
Try to nicely explain the situation and get all the audiences out of the shots

Person/company responsible Myself

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

Risk removed? (y/n)

Hazard no:11
Description

Risk Factor (1-5)

2
Working in Autumn, on top of the hill, might be very cold (as low as 5 degrees) on
the shooting day.

Person(s) exposed (detail if

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

C
Providing hats, gloves and hot drinks between scenes, making sure every member
of crew is comfortable

Person/company responsible Myself

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

Hazard no:21

Risk Factor (1-5)

Risk removed? (y/n)

Description

Members of the crew are smokers, however we will work with under aged child (3
years old)

Person(s) exposed (detail if

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

C
Make sure the youngest member of crew is no where near the member of crew who
will be smoking at the time

Person/company responsible Myself

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

Risk removed? (y/n)

Hazard no:30
Description

Risk Factor (1-5)

3
As it is the hill where it is possible to see the whole city, it is at a very high level, no
fences or anything.

Person(s) exposed (detail if

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

C, O
Make sure every member of crew is aware of the environment before starting to
shoot in order to familiarize them with the environment and avoid accidents. The
youngest member of the crew in the eye sight even between scenes
Myself and the mother of the child

Person/company responsible
for action
To be completed at agreed later date Exposed person(s)
Agreed action taken? (y/n)
informed? (y/n)

Risk removed? (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: Evelina Vysniauskaite

Position: Director

Signature: E.Vysniauskaite

Date: 14/10/2015

Countersigned by: Evelina Vysniauskaite

Signature: E.Vysniauskaite

PRODUCER
Date: 14/10/2015