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25 - 34 pounds <br />35 - 50 pounds <br />51 - 74 pounds X <br />75 - 100 lbs. <br />From what height to what height? <br />Ground to shoulder height. <br />Are the following weights carried? If yes, describe. <br />How far are these weights carried? <br />0 - 10 pounds <br />11 - 24 pounds <br />25 - 34 pounds <br />35 - 50 pounds <br />51 - 74 pounds X <br />75 - 100 lbs. <br />1 foot to 20 feet. <br />Job requires: <br />Working outdoors? Yes <br />Working indoors? Yes <br />Operating forklifts, dangerous Yes <br />machinery or vehicles? <br />Supervising other employees? No <br />Working with chemicals? Yes <br />Working near fumes/vapors? Yes <br />Driving City vehicle or personal vehicle? <br />PDI Points: <br />Created/Revised: January 27, 2005 <br />Revised: July 16, 2008 <br />7 <br />Yes Driving is an <br />essential <br />requirement. <br />