NEVER (N)
OCCASIONALLY (O)
FREQUENTLY (F)
CONSTANTLY (C)
0 % of Shift
1-33% of Shift
34-66% of Shift
67-100% of Shift
Working Conditions
N
O
F
C
Physical Demands
Depth Perception
X
Standing
Color Distinction
Walking
Peripheral Vision
Sitting
Driving
Lifting
Physical Strength:
Carrying
Little Physical Effort (-10 lbs.)
Pushing
Light Work (-20 lbs.)
Pulling
Medium Work (20-50 lbs.)
Climbing
Heavy Work (50-100 lbs.)
Balancing
Very Heavy Work (100+ lbs.)
Stooping
Environmental Conditions
Kneeling
Cold (50 degrees F or less)
Crouching
Heat (90 degrees F or more)
Crawling
Temperature Changes
Reaching
Wetness
Handling
Humidity
Grasping
Extreme Noise or Vibration
Twisting
Exposure to Chemicals
Feeling
Exposure to Gases and Fumes
Talking
Exposure to Unpleasant Odors
Hearing
Exposure to bodily fluids
Repetitive Motion
Exposure to dampness
Hand/Eye/Foot Coordination
Confinement to Small or Restricting Area
Visual Acuity/Near
Mechanical Hazards
Visual Acuity/Far
Physical danger or abuse