WORK ENVIRONMENT/PHYSICAL DEMANDS WORKSHEET
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IN AN EIGHT (8) HOUR WORK DAY, THIS JOB REQUIRES: |
R - Rarely (Less than ½ hour per day) |
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O - Occasionally (½ - 2½ hours per day) |
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F - Frequently (2½ - 5½ hours per day) |
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C - Continually (5½ - 8 hours per day) |
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N/A - Not Applicable |
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PHYSICAL REQUIREMENTS: |
R |
O |
F |
C |
N/A |
Comments |
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Sitting |
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X |
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Stationary Standing |
X |
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Walking |
X |
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Ability To Be Mobile |
X |
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Crouching (bend at knees) |
X |
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Kneeling/Crawling |
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X |
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Stooping (bend at waist) |
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X |
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Twisting (knees/waist/neck) |
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X |
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Turn/Pivot |
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X |
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Climbing |
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X |
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Balancing |
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X |
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Reaching Overhead |
X |
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Reaching Extension |
X |
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Grasping |
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X |
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Pinching |
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X |
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Pushing/Pulling: Typical Weight |
X |
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Pushing/Pulling: Maximum Weight |
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X |
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Lifting/Carrying: Typical Weight |
X |
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Lifting/Carrying: Maximum Weight |
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X |
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Manual Dexterity (Keyboarding) |
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X |
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Talking in Person |
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X |
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Talking on Telephone |
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X |
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Hearing in Person |
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X |
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Hearing on Telephone |
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X |
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Other Sensory Requirements: |
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X |
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Environment Setting: |
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Exposures to fumes |
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X |
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Exposures to chemicals |
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X |
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Exposures to vibrations |
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X |
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Exposures to excessively loud noise |
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X |
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Exposures to heat, cold, humidity,etc |
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X |
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Any of Exposures |
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Operation of Equipment |
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X |
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Operation of Tools |
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X |
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Operation of Vehicles |
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X |
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Other Environmental Requirements |
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X |
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