Job Analysis/Job Description Physical Activities Checklist

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Job title:__________________________________________

Department:______________________________________


Physical Activities

Check all that apply

Frequency

(N)Never, (O)Occasionally or (C)Constantly

Ascending or descending ladders, stairs, scaffolding, ramps, poles and the like. 
Moving self in different positions to accomplish tasks in various environments including tight and confined spaces. 
Remaining in a stationary position, often standing or sitting for prolonged periods. 
Moving about to accomplish tasks or moving from one worksite to another. 
Adjusting or moving objects up to __ pounds in all directions. 
Communicating with others to exchange information. 
Repeating motions that may include the wrists, hands and/or fingers. 
Operating machinery and/or power tools. 
Operating motor vehicles or heavy equipment. 
Assessing the accuracy, neatness and thoroughness of the work assigned. 

Environmental Conditions

Check all that apply

Frequency

(N)Never, (O)Occasionally or (C)Constantly

Low temperatures. 
High temperatures. 
Outdoor elements such as precipitation and wind. 
Noisy environments. 
Hazardous conditions. 
Poor ventilation. 
Small and/or enclosed spaces. 
No adverse environmental conditions expected.  

Physical Demands 

Check only one 


Sedentary work that primarily involves sitting/standing.
 
Light work that includes moving objects up to 20 pounds. 
Medium work that includes moving objects up to 50 pounds. 
Heavy work that includes moving objects up to 100 pounds or more. 



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