LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE: Pants to Poverty PRODUCTION OFFICE PHONE/MOBILE: LOCATION THIS FORM RELATES TO: City College Norwich Start Up Lounge

SHOOT DATE/S: 25th March

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 Y Y L L U U 2 1 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: Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

4 Risk Factor (1-5) There is a camera in the room C

Have the camera in a place where it doesnt get in peoples way and make sure it isnt left out

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

5 Risk Factor (1-5) The room filming will be in is small so space is limited. C

Nobody is to run at all. Make sure the equipment doesnt get in the way of the cast/crew

Person/company responsible Mark Rainsford for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) informed? (y/n) Hazard no: 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)

Person/company responsible for action To be completed at agreed later date Exposed person(s) Agreed action taken? (y/n) Risk removed? (y/n) informed? (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: Mark Rainsford Signature Position:Director Date: 25th March 2013