RISK ASSESSMENT RECORDING FORM
Location or Date Assessment
Address: 12 Church Rd, Barnton, Northwich CW8 Undertaken: 10/02/2023
4JH
Activity or Review
Situation Filming a music video Date: 10/03/2023
(1) Hazard Risk (2) Who might be harmed and how?
A drink could spill on the filming A1 x People who are handling or near the
equipment B3= equipment could spill a drink on the
C3 equipment that could break the
camera and injure the person by
giving them a cut or a burn from the
camera potentially setting a flame
Weather Conditions 1a x The crew and the actors could be
2b = affected by the weather conditions
2c because the floor could be wet and
that could lead to someone slipping.
Also the equipment might be
damaged by bad weather conditions
The Road 4a x The crew and the actors could be
2b = affected by this because we are
8c filming near a road that is used
regularly. This road could be
dangerous to film because if
somebody isn’t being careful there's
a chance that there could be an
accident which will lead to a serious
injury.
Assessment undertaken
By: Charlie Parkes
Signature
x
(3) What controls exist to reduce (4) What action can be taken
risk to further reduce risk?
make sure that the camera make sure that the equipment is in
operator and the equipment are out a safe/secure area that won’t fall
of the way around the furniture etc and make sure crew are careful
and if they have to go closer to with the filming equipment such as
furniture or something that they cameras etc.
could deem as unstable then they
must walk securely and be careful
with the equipment
I will make sure that everyone N/A
knows the risk of the weather
conditions and if it gets worse then
we will move the filming day
forward to a day where there is
more stable weather.
I will make sure that everyone is Make sure that everyone stands
aware of the risks that are possible further away from the road, this
when filming next to the road and will result in a reduction of the risk
make sure that everyone is careful level
while we are filming.
 1. List hazards something with the potential to cause harm here:
Seek to quantify the level of risk the likelihood of harm arising based on the number of persons affected, how often they are exposed to the hazard and the
severity of any consequence.
2. List groups of people who are especially at risk from the significant hazards which you have identified
3. List existing controls here or note where the information may be found
4. List the risks which are not adequately controlled and the action you will take. Have regard for the level of risk, the cost of any action and the benefit you expect to
gain.

RISK RATING

a SEVERITY b LIKELIHOOD c FINAL SCORE RATING: what needs to be done

5 Dying or being permanently disabled 5 Will almost certainly happen 16-25 Stop! Do not start activity again until risk is
controlled
4 Serious injury/long term illness 4 Highly likely to happen 10-15 High risk level, High priority. Take action
straight away to control the risk
3 Temporary disability/3 days off sick 3 Not so likely 6-9 Medium risk level. Tighten up controls and
make a plan to do something about risk
2 Will need medical attention 2 Even less likely 3-5 Fairly low risk level. Low priority but keep
possible action in mind
1 Minor injury eg. Bruise, graze 1 Unlikely to happen at all 1-2 Low or trivial risk. No further action
required.

SO: a x b = c

Action Required Responsible Person Date for Completion