Pre-Tech Scout Location Hazard Checklist

Pre-Tech Scout Location Hazard Checklist

This form can be updated and edited after submission. See instructions below.
Show*
Working Title
If different from Show
Episode*

Location 1
Scene Number(s)*
Date of Shoot*

MonthDayYear
If multiple days, use first day
Residence or Business Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are any of these hazards present?*

	Present?	Mitigation	Notes
Visible mold
Fall hazards
Walking hazards
Hazardous materials
Housekeeping concerns
Structural concerns
Potential Asbestos
Other
None

Are any of the following planned for this location?*

	Planned	Possible	Description
Minors working
Stunts: Actor Action
Stunts: Vehicles
Stunts: Other
SPFX: Smoke/Fog
SPFX: Explosions
SPFX: Other
Water Work

Photos or diagrams

Browse Files
On mobile this can open your camera or camera roll Cancelof
Notes on Location 1

Location 2
Scene Number(s)
Date of Shoot

MonthDayYear
If multiple days, use first day
Residence or Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are any of these hazards present?

	Present?	Mitigation	Notes
Visible mold
Fall hazards
Walking hazards
Hazardous materials
Housekeeping concerns
Structural concerns
Potential Asbestos
Other
None

Are any of the following planned for this location?

	Planned	Possible	Description
Minors working
Stunts: Actor Action
Stunts: Vehicles
Stunts: Other
SPFX: Smoke/Fog
SPFX: Explosions
SPFX: Other
Water Work

Photos or diagrams

Browse Files
On mobile this can open your camera or camera roll Cancelof
Notes on Location 2

Location 3
Scene Number(s)
Date of Shoot

MonthDayYear
If multiple days, use first day
Residence or Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are any of these hazards present?

	Present?	Mitigation	Notes
Visible mold
Fall hazards
Walking hazards
Hazardous materials
Housekeeping concerns
Structural concerns
Potential Asbestos
Other
None

Are any of the following planned for this location?

	Planned	Possible	Description
Minors working
Stunts: Actor Action
Stunts: Vehicles
Stunts: Other
SPFX: Smoke/Fog
SPFX: Explosions
SPFX: Other
Water Work

Photos or diagrams

Browse Files
On mobile this can open your camera or camera roll Cancelof
Notes on Location 3

Location 4
Scene Number(s)
Date of Shoot

MonthDayYear
If multiple days, use first day
Residence or Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are any of these hazards present?

	Present?	Mitigation	Notes
Visible mold
Fall hazards
Walking hazards
Hazardous materials
Housekeeping concerns
Structural concerns
Potential Asbestos
Other
None

Are any of the following planned for this location?

	Planned	Possible	Description
Minors working
Stunts: Actor Action
Stunts: Vehicles
Stunts: Other
SPFX: Smoke/Fog
SPFX: Explosions
SPFX: Other
Water Work

Photos or diagrams

Browse Files
On mobile this can open your camera or camera roll Cancelof
Notes on Location 4

Location 5
Scene Number(s)
Date of Shoot

MonthDayYear
If multiple days, use first day
Residence or Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are any of these hazards present?

	Present?	Mitigation	Notes
Visible mold
Fall hazards
Walking hazards
Hazardous materials
Housekeeping concerns
Structural concerns
Potential Asbestos
Other
None

Are any of the following planned for this location?

	Planned	Possible	Description
Minors working
Stunts: Actor Action
Stunts: Vehicles
Stunts: Other
SPFX: Smoke/Fog
SPFX: Explosions
SPFX: Other
Water Work

Photos or diagrams

Browse Files
On mobile this can open your camera or camera roll Cancelof
Notes on Location 5

Location 6
Scene Number(s)
Date of Shoot

MonthDayYear
If multiple days, use first day
Residence or Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are any of these hazards present?

	Present?	Mitigation	Notes
Visible mold
Fall hazards
Walking hazards
Hazardous materials
Housekeeping concerns
Structural concerns
Potential Asbestos
Other
None

Are any of the following planned for this location?

	Planned	Possible	Description
Minors working
Stunts: Actor Action
Stunts: Vehicles
Stunts: Other
SPFX: Smoke/Fog
SPFX: Explosions
SPFX: Other
Water Work

Photos or diagrams

Browse Files
On mobile this can open your camera or camera roll Cancelof
Notes on Location 6

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