LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE: Experimental Impressions Promotional Video PRODUCTION OFFICE PHONE/MOBILE: 07786524362 LOCATION THIS FORM RELATES TO: Walcott Beach

SHOOT DATE/S: 11/04/13

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

Calculate the Risk Factor:

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

Decide the action to take: 5 Very severe 4 Severe 3 Moderate Risk 2 Low Risk 1 Negligible

Take immediate action High priority Programme for action Action may be required Probably acceptable

Then list each risk identified

Hazard no: 2 Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

Risk Factor (1-5) Animals/insects My client and I Be aware of our surroundings

Person/company responsible My client and I 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: 3 Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

Risk Factor (1-5)

Audiences

My client and I Be aware of our surroundings and to not cause a scene to create an audience while filming. Also, to make sure to not capture anyone on film

Person/company responsible My client and I for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) informed? (y/n) Hazard no: 6 Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

Risk removed? (y/n)

Risk Factor (1-5) Derelict buildings/dangerous structures My client and I

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

As we are filming on a beach there is danger of cliff erosion and also the sea. Making sure that everyone is safe and keeps a distance from any broken or damage footpath/cliff edge. My client and I Y Risk removed? (y/n)

Hazard no:16

Risk Factor (1-5)

Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

Noise high sound levels My client and I As the beach is next to a road there will be noise from the traffic. To film away from the road to avoid noise.

Person/company responsible My client and I for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) informed? (y/n) Hazard no:21 Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

Risk removed? (y/n)

Risk Factor (1-5) Smoking on set My client and I

To smoke either after or before shooting and to keep distant from the public

Person/company responsible My client and I for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) informed? (y/n) Hazard no:27 Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take Vehicles/speed My client and I

Risk removed? (y/n) 3

Risk Factor (1-5)

Be aware of our surroundings and to keep our distance from the road.

Person/company responsible My client and I 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)

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: ZM Editor Signature Position: Director, Producer, Camera Operator, & Date: 11/04/13

Countersigned by: Signature

PRODUCER Date: