Laserfiche WebLink
CHECK THE BLOCKS TO SHOW THE ENVIRONMENTAL CONDITIONS UNDER WHICH YOU PERFORM <br /> THE ESSENTIAL JOB FUNCTIONS AND HOW FREQUENTLY THEY OCCUR DURING THE WORK WEEK. <br /> vrr CODE: CONSTANT: More than 80 % ( 6 '/� hours or more per 8 hour day . ) <br /> VERY FREQUENT: 51 % - 79 % (4Y= - 6 hours per 8 hour day . ) <br /> FREQUENT : 21 % - 50 % ( 2 %, - 4 hours per 8 hour day . ) <br /> OCCASIONAL: 6 % - 20 % ( 1 - 2 hours per 8 hour day . ) <br /> RARELY : 0 % - 5 % (Less than 1 hour per 8 hour day . ) <br /> TYPES OF VERY <br /> ENVIRONMENTAL CONDITIONS CONSTANT FREQUENT FREQUENT OCCASIONAL RARELY <br /> Work inside <br /> Work outside <br /> In heat <br /> In cold <br /> In high humidit <br /> In dam ness or chilliness rj <br /> In dr conditions <br /> In or with nois conditions t/ <br /> In darkness - Where? <br /> in or with dust eonditions <br /> With Silica , Asbestos, etc . <br /> With fumes or gases <br /> With chemicals - What t es7 - <br /> With solvents - What t es ? <br /> r.— <br /> With grease or oils <br /> vaw With radiant energy y J <br /> With electrical energy0. <br /> On slippery surfaces <br /> On uneven surfaces <br /> In or with movin2 objects �- <br /> In or with moving vehicles �— <br /> On or with ladders/scaffolding <br /> At heights above ground level up rl <br /> to feet <br /> Below ground level(ditches ,tunnels ,etc.) <br /> With feet, legs , or hands in water ✓ <br /> �l <br /> With explosives <br /> With vibrations <br /> Working closely with others <br /> Working alone <br /> With poor lighting - Where? <br /> With poor ventilation - Where? <br /> With odors - Where ? <br /> OTHER : ( Describe any other conditions not covered above in this block) <br /> WORK HAZARDS : <br /> r 15 <br /> SAFETY EQUIPMENT USED OR NEEDED : <br /> %w <br />