EIEIEI Risk Assessment Form - Part A Blank Template
Reference: | [enter reference number]l Sign-off status I plan ni ng / a pproved etc]
Assessment summary details
C A""."".ent title x(Simple name for referencepurposes)
Tsrv q + \o So*rol cgfiLcL' ficor$ing
*3 oiri"ion,x \-\t1,,.".. P.r.+ t.\,.*, $ Department:x p*r.1,c.,
B series/ Prod/Unit: lE Prog.urnme/Area:
O ResponsibleManager:
{i} contact office:
Add ress/Tel : Address/Tel:
Date assessment created trlel t6Confidential riskassessment?
YES/NO (delete as applicable)
E A"".""-ent outline(Summary of what isnronosed)
Re*n,Ili3 So..+.cfr q+trclS
O A"".""-ent startdate
B nevlew / End date
*{l count.y location L\KiE uostile / traveladvisory?
& tocation details Ha<rrr^ CIo"t SrLocr,Prastwd reoc\
\a\rl rt Q-0
NB: If the country location selected is'Hostile' you arerequired to: complete the BBC Overseas High RiskAssessment Form
J Crew / team(Roles, responsi bil ities,com petencies)
Jerdon --Tcr..s R".oudi15 u,* sourrd. eefscts
E Attachments(Detail supportingdocuments)
{l A"""""or(s) x(Person drafting riskassessment)
O A"".""or safetycompetence
J Authoriser(s)(Person responsibles ig n -off)
$
for A.i*r... ()rcuir^rrDate signed-off x
lE oistribution(Who gets a copy of theassessment)
Data protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and
those involved in controlling risk, from this or similar activities and to fulfil the BBC'S obligations under Health and Safety policy and
legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, includingour agents and contractors, with whom the risk or the control of risk is shared.
SActlrity and Hazard Summar! [This is a summary of the activities listed in part B of the risk assessment.]
Activity Who Exposed Hazards{hazard titles I Activity Risk Rating
LatuL.,.t,, c-.ic\ (-trc:r'ri.inci :iX I {*{.o" To,"^s I E,".trocuf,io,r , i'**,i^ql LOr;
Comments log
Who by Date / timereceived
Comments I Assessor resPonse Date/ timeresponded