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FORM RA 002 (adapted for Student Media Productions)

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Equipment booking

Name of hirer
chloe coleman


Facility / equipment required
Catalogue code Description Hours/days Unit
cost
Cost
SONY HD CAMERA 4 DAYS
TRIPOD 4 DAYS
MICROPHONE AND HEADPHONES 4 DAYS



Total


Date Time
Issue 16/10/14 1:30PM
Return 20/10/14 10:15AM


Please give as much notice as possible. Location filming requests MUST be submitted at least
48 hours in advance to ensure batteries can be charged etc.



FORM RA 002 (adapted for Student Media Productions)
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Call sheet

Production title INTERVIEWS
Call sheet for (date) 16/10/14


Production team
Names Roles Contact details
CHLOE COLEMAN ALL 7511772304


Actors
HAZEL CHECKSFIELD INTERVIEWEE






Base address and contact details:
1 HONEYSUCKLE CLOSE CALNE WILTSHIRE SN11 2TE



Location address: 1 HONEYSUCKLE CLOSE CALN WILTSHIRE 2TE

Map attached.

Access info: KNOCK ON DOOR

Contact details: AS ABOVE

Travel arrangements: NONE



FORM RA 002 (adapted for Student Media Productions)
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Times

Meet time at base: 6:30PM

On location 6:30PM

Shoot time (s) and scene numbers 1 INTERVIEW

Planned breaks and catering arrangements TAKEN WHEN NEEDED

Projected wrap time 7PM

Back at base time 7PM


Weather report (if outside)
N/A


Special considerations with regard to location/weather/activities etc

N/A


FORM RA 002 (adapted for Student Media Productions)
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RISK ASSESSMENT FOR LOCATION
FILMING
DATE OF
ACTIVITY
17/10/14
TASK / ACTIVITY
INTERVIEWS
DATE
ASSESSED

BRIEF DESCRIPTION
INTERVIEWS
RISK RATING
(likelihood consequence = )
1
See Risk Assessment Assistant (Page 3) for scoring.
Include the risk word (i.e. acceptable, adequate, tolerable, unacceptable).
PEOPLE

PERSONNEL PROFILE / TRAINING GIVEN
NUMBER OF PEOPLE UNDERTAKING TASK 2
DURATION OF TASK 1 HOUR
PERSONNEL INSTRUCTED PERSONNEL INSTRUCTED PERSONNEL INSTRUCTED
STAFF 0 TALENT 1 YOUNG PERSON 2
STUDENT 1 CONTRIBUTORS 0 VISITOR 0
PUBLIC 0
PERSONNEL
WORKING ALONE
0
DISABLED 0
SPECIALIST TRAINED
PERSONNEL
0
CONTROL MEASURES IN PLACE (Guarding, Safe Systems of Work, PPE, etc)
FORM RA 002 (adapted for Student Media Productions)
Page 5 of 11
TO BE COMPLETED BY STAFF ASSESSOR(S) (Ctrl+Tab to add tab stops between columns)
EXTRA ACTIONS REQUIRED TO CONTROL SIGINIFICANT RISKS ACTIONED BY DATE
STUDENT ASSESSOR(S)

STAFF ASSESSOR(S)


FORM RA 001
611
HAZARD IDENTIFICATION
ACTIVITY / TASK

INTERVIEWS
HAZARD TYPE PRESENT
COMMENTS
HAZARD TYPE PRESENT
COMMENTS
1. Mechanical / Physical Hazards YES NO 4. Production Hazards YES NO
1.1 Slips / Trips / Falls
X 4.1 Stressful Postures

X

1.2 Vehicles

X 4.2 Lifting / Handling

X

1.3 Camera Grip Equipment

X 4.3 Inadequate Breaks

X

1.4 Falling Equipment

X 4.4 Restricted Visibility (viewfinder)

X

1.x Other Mechanical Hazards

X 4.5 Camera Tracking/Crabbing

X

2. Electrical Hazards YES NO COMMENTS 4.6 Working at Height

X

2.1 Direct Contact

X

4.x Other Workplace Hazards

X

2.2 Indirect Contact

X

5. Hazardous Substances YES NO COMMENTS
2.3 Short Circuit / Overload

X

5.1 Explosive / Biological / Chemical

X

2.4 Source of Ignition

X

5.2 Substances in set construction

X

2.5 Proximity to Water

X

5.x Other Hazardous Substances

X

3. Production Activities YES NO

6. Environmental Hazards YES NO COMMENTS
3.1 Extreme Sports

X

6.1 Localised Hot / Cold Surfaces

X

3.2 Animals (working with or proximity to)

X

6.2 High / Low Ambient Temp.

X

3.3 Fight sequences

X

6.3 Poor Lighting

X

3.4 Potential Intervention from Public

X

6.4 Confined spaces

X

3.5 Potential for Assault

X

6.5 Poor Weather

X

3.6 Noise pollution

X

6.6 Uneven/Slippery Surfaces

X

FORM RA 001
711
3.7 Smoking

X

6.7 Unsafe structures

X

3.8 Alcohol

X

6.8 Sharps & breakages

X

3.x Other Production Activity Hazards

X

6.x Other Environmental Hazards

X


FORM RA 001
811
RISK ASSESSMENT ASSISTANT
These are the basic terms that apply to a Risk Assessment:
A hazard is anything that has the potential to cause harm. This could be something as specialised as a piece of
complicated machinery, or as commonplace as a cup of coffee. If it could be harmful in any way, then its a
hazard.
A hazardous event takes place when someone or something interacts with the hazard and allows it to cause
harm. Take a hole in the ground for example. The hole (the hazard), by itself isnt causing any harm, but if
someone tripped over it (the hazardous event) then it would become harmful. Every hazardous event has a
likelihood and a consequence.
Likelihood is a measure of the chance that the hazardous event will occur. If the hole is in a busy area, such as
a shop entrance, its more likely someone will trip over it. However if its in an area that doesnt get a lot of traffic,
such as a back yard, tripping over it would be less likely.
The consequence is the outcome of the hazardous event. If you tripped over a hole, there could be several
possible outcomes; you might land on your feet with no damage at all, you might drop whatever you are carrying,
or perhaps you could end up with a sprained ankle or even a fracture.
Risk is the combination of the likelihood of a hazardous event occurring and the consequence of the event.
Risk = likelihood x consequence
Below is a table to help you work out the score for the likelihood and consequence. Once you have done this,
multiply the two numbers to get the Risk Rating.
Likelihood
Risk
Score
Consequence
Very unlikely might happen once in 5 years 1 No injury
Unlikely would not happen in 2-3 years 2 Minor - minor injury requiring first aid
Fairly Likely would expect to happen once a year 3 Moderate - up to three days absence
Likely could occur 2-3 times a year 4 Major more than three days absence
Very Likely likely to happen 2-3 times a week 5 Catastrophic Death or multiple deaths

Risk Matrix this is used for estimating and evaluating the risk it is a commonly used tool. Usually the higher the
risk level, the more serious the risk and the more likely youll need to take action.
FORM RA 001
911

FORM RA 001
1011




C
O
N
S
E
Q
U
E
N
C
E
5 10 15 20 25
4 8 12 16 20
3 6 9 12 15
2 4 6 8 10
1 2 3 4 5
LIKELIHOOD







UNACCEPTABLE Stop the activity and make
immediate improvements

TOLERABLE look to improve within a specified
timescale

ADEQUATE Look to improve at next review

17-25
10-16
5-9
1-5
FORM RA 001
1111


If you are still not sure or just have a question, please do not hesitate in contacting the Health & Safety
Department We are here to help!

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