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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 /> CODE: CONSTANT: More than 80 % ( 6 %2 hours or more per 8 hour day . ) <br /> VERY FREQUENT : 51 % - 79 % (4 '/2 - 6 hours per 8 hour day . ) <br /> FREQUENT: 21 % - 50 % ( 2 '/2 - 4 hours per 8 hour day . ) <br /> OCCASIONAL: 6 % - 20 % 0 - 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 /> J <br /> In cold <br /> In high humidity <br /> In dampness or chilliness ✓ <br /> In dry conditions <br /> In or with noisy conditions <br /> In darkness - Where? <br /> in or with dusty conditions <br /> With Silica , Asbestos , etc . <br /> With fumes or oases <br /> With chemicals - What t es ? <br /> With solvents - What t es ? J <br /> t� <br /> With grease or oils <br /> %w With radiant ener J <br /> Leo— <br /> With electrical energy <br /> On slippery slippersurfaces <br /> On uneven surfaces <br /> fr <br /> In or with moving obiects <br /> In or with moving vehicles �— <br /> On or with ladders/scaffoldin <br /> At heights above ground level up �_- <br /> to feet <br /> Below ground level (ditches,tunnels,etc <br /> With feet, legs, or hands in water ✓ �� <br /> With ex losives <br /> With vibrations <br /> Working closely with others t/ <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 /> 15 - <br /> SAFETY EQUIPMENT USED OR NEEDED : <br /> - 3- <br />