Not at all | Occasionally | Frequently | Continuously | |
Bend Stoop | X | |||
Squat | X | |||
Crawl | X | |||
Climb-Height | X | |||
Reach above shoulder level | X | |||
Crouch | X | |||
Kneel | X | |||
Balance | X | |||
Push/Pull | X |
Never | Occasionally | Frequently | Continuously | |
Up to 10 lbs | X | |||
11 – 24 lbs | X | |||
25 – 34 lbs | X | |||
35 – 50 lbs | X | |||
51 – 74 lbs | X | |||
75 – 100 lbs | X |
Simple Grasping | Firm Grasping | Fine Manipulation | |
Right | Yes | Yes | Yes |
Left | Yes | Yes | Yes |
Yes | No | Comments | |
Working on unprotected heights | X | ||
Being around moving machinery | X | ||
Exposure to marked changes in temperature and humidity | X | ||
Driving automotive equipment | X | Out trips | |
Exposure to dust, fumes and gases | X |