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Are the following weights lifted? <br /> <br /> 0-10 pounds <br />11-24 pounds <br />25-34 pounds <br />35-50 pounds <br />51-74 pounds <br />75-100 pounds <br /> <br />If yes, describe. <br /> <br />What object(s) are lifted: <br /> <br />Must be able to handle people, tools, ladders, <br />appliances, and other apparatus. Heaviest single <br />tool (Hurst tool) is approximately 80 lbs. <br /> <br />From what height to what height? <br />0 to 15 feet. <br /> <br />Are the following weights carried? If yes, describe. <br /> <br /> How far are these weights carried? <br /> <br /> 0- 10 pounds <br /> <br />11- 24 pounds = <br />25- 34 pounds <br />35-50 pounds <br />5t-74 pounds <br />75-100pounds X <br /> <br />0 foot to 50 feet. <br /> <br />May be expected to carry same as lifting. <br /> <br />Job requires: <br /> <br /> Working outdoors? <br /> <br /> Working indoors? <br /> <br /> Operating forklifts, dangerous <br /> machinery or vehicles? <br /> <br />X Yes <br />X Yes <br /> <br />X Yes <br /> <br />No <br /> <br />No <br /> <br />Fire Chief <br />Page 7 of B <br /> <br /> <br />