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FORM RA 002 (adapted for Student Media Productions)

Equipment booking
Name of hirer

Mollie Tuck

Facility / equipment required


Catalogue
code

Issue
Return

Description

Day

DLSR camera
Tripod
Boom
Zoom

1
1
1

Date
03/03/15
03/03/15

Unit
cost ()

Cost

75
75
75
75
300 Total

Time
9:00
3:00

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.

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FORM RA 002 (adapted for Student Media Productions)

Call sheet
Production title
Call sheet for (date)

SU
03/03/15

Production team
Names

Roles

Contact details

Mollie Tuck

Camera and Director

07581 886740

Actor
Actor
Actor

07857 166155
07350 162355
07709 236105

Actors
Kirsty Warren
Ryan Miles
Matt Provis

Base address and contact details:


Wiltshire College: Chippenham Campus
Cocklebury Road
Chippenham
Wiltshire
SN15 3QD
Telephone 01249 464644
Fax 01249 465326
Email info@wiltshire.ac.uk
Access information: There is easy access to the media studio in Wiltshire college: Chippenham campus, with ramps to
help the less abled.
Travel arrangements: Everyone is to make their own way there.
There is a fire exit if it is absolutely necessary.

Location address:
Wiltshire College: Chippenham Campus
Cocklebury Road
Chippenham
Wiltshire
SN15 3QD
John Coles Park
Cocklebury Road
Chippenham
Wiltshire
SN15 3QD
My House
2 Claypole Mead
Chippenham
Wiltshire
SN15 3GW

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FORM RA 002 (adapted for Student Media Productions)

Times
Meeting time at base 09:00 am
Project wrap time 14:30 pm
Back at base time 15:00 pm
Planned breaks and catering arrangements will be done throughout and at reliant times.

Weather report (if outside)


It will be sunny.

Special considerations with regard to location/weather/activities etc


Wear hard shoes when working - this is due to working with heavy and dangerous equipment.
Prop cans to be brought by Mollie and Ryan.
Notify actors beforehand.

RISK ASSESSMENT FOR LOCATION FILMING

DATE OF
ACTIVITY

TASK / ACTIVITY

DATE
ASSESSED

SU

03/03/15

BRIEF DESCRIPTION
A Interactive Film.

RISK RATING
(likelihood consequence = )

See Risk Assessment Assistant (Page 3) for scoring.

Include the risk word (i.e. acceptable, adequate, tolerable, unacceptable).

PEOPLE Mollie Tuck, Kirsty Warren

NUMBER OF PEOPLE UNDERTAKING TASK

PERSONNEL PROFILE / TRAINING GIVEN

DURATION OF TASK

PERSONNEL

INSTRUCTED

PERSONNEL

INSTRUCTED

3 days
PERSONNEL

INSTRUCTED

STAFF

TALENT

YOUNG PERSON

STUDENT

CONTRIBUTORS

VISITOR

PUBLIC

PERSONNEL
WORKING ALONE

DISABLED

SPECIALIST TRAINED
PERSONNEL

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FORM RA 002 (adapted for Student Media Productions)

CONTROL MEASURES IN PLACE (Guarding, Safe Systems of Work, PPE, etc)


First aider accessible

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) Mollie Tuck


STAFF ASSESSOR(S)

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FORM RA 001

HAZARD IDENTIFICATION
HAZARD TYPE
1. Mechanical / Physical Hazards

PRESENT
YES

NO

ACTIVITY / TASK
SU
COMMENTS

HAZARD TYPE
4. Production Hazards

PRESENT
YES

NO

1.1 Slips / Trips / Falls

1.2 Vehicles

1.3 Camera Grip Equipment

Tripod is the only hazard.

4.3 Inadequate Breaks

1.4 Falling Equipment

Camera falling from Tripod.

4.4 Restricted Visibility (viewfinder)

4.5 Camera Tracking/Crabbing

4.6 Working at Height

There may be vehicles in the park.

1.x Other Mechanical Hazards


2. Electrical Hazards

Trip on the tripod.

YES

NO

COMMENTS

4.1 Stressful Postures


4.2 Lifting / Handling

Could be a hazard if you slip


with the camera in your hand

If the grass is moist someone


could slip

2.1 Direct Contact

4.x Other Workplace Hazards

2.2 Indirect Contact

5. Hazardous Substances

YES

2.3 Short Circuit / Overload

5.1 Explosive / Biological / Chemical

2.4 Source of Ignition

5.2 Substances in set construction

5.x Other Hazardous Substances

2.5 Proximity to Water


3. Production Activities

YES

3.1 Extreme Sports


3.2 Animals (working with or proximity to)

3.5 Potential for Assault

6. Environmental Hazards

6.1 Localised Hot / Cold Surfaces

6.2 High / Low Ambient Temp.

Birds/Dogs in the park.

6.3 Poor Lighting


Possibly while in the park.

YES

NO

NO

3.3 Fight sequences


3.4 Potential Intervention from Public

Filming near the river

NO

COMMENTS

COMMENTS

Due to inside lighting.

6.4 Confined spaces


6.5 Poor Weather

COMMENTS

It is a potential hazard but


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FORM RA 001

unlikely
3.6 Noise pollution

Yes from traffic .

6.6 Uneven/Slippery Surfaces

On the grass

3.7 Smoking

6.7 Unsafe structures

3.8 Alcohol

6.8 Sharps & breakages

3.x Other Production Activity Hazards

6.x Other Environmental Hazards

Slippery surface

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FORM RA 001

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

No injury

Unlikely would not happen in 2-3 years

Minor - minor injury requiring first aid

Fairly Likely would expect to happen once a year

Moderate - up to three days absence

Likely could occur 2-3 times a year

Major more than three days absence

Very Likely likely to happen 2-3 times a week

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.

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CONSEQUENCE

FORM RA 001

UNACCEPTABLE Stop the activity and make


15immediate
20 improvements
25
17-25
12
16
20

10

9 TOLERABLE
12
15 look to improve within a specified
timescale
10-16
6
8
10

4
5
ADEQUATE Look to improve at next review
LIKELIHOOD
5-9

1-5
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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