Download Work Safety Conditions

Work Safety Conditions
Job Hazards (safety training required)
Select the following hazards the employee will be directly exposed to in their work environment:
Animals
Confined space entry
Radioactive materials
Around moving machinery
Excessive noise
Repetitive motion
Baseline evaluation of
FBI check/fingerprinting
Restricted access
hearing required
Baseline evaluation of vision
Fumes, dust, others
Powered industrial vehicle
required
(fork, reach, bucket lift)
Bloodborne pathogens
Infectious agent
Select agents
Chemicals
Laser
UV light
Commercial products
Pesticides or herbicides
X-ray
Comments:
Job Tasks
Select the following tasks assigned to the employee:
Lifting up to Select lbs
Security
Respirator use
Plant/Facility maintenance
Physical exertion
Custodial duties
DOT shipping/receiving of hazardous, biological or infectious
Grounds (lawn maintenance)
materials
Other:
Explain if employee is responsible for individuals under the age of 18 years:
Personal Protective Equipment Required
Select the following equipment needed to perform the job:
Appropriate gloves
Lab coat
Hard hat
Protective eyewear
Hearing protection
Other:
Respiratory protection
Safety shoes
Ergonomic Concerns
Select the activities required to perform the job:
Balance
Crouch
Bend/Stoop
Keyboard/Type
Climb ladders
Kneel
Climb stairs
Squat
Crawl
Push/Pull
Explain:
Reach
Reach above shoulder
Repetitive motion
Use computer mouse
Travel Requirements
Employee will be required to drive while on the job
Employee will operate university vehicle
Valid Ohio driver’s license required
Chauffeur driver’s license required (pre-employment testing and drug testing required)
Commercial driver’s license required (pre-employment testing and drug testing required)
Employee will transport hazardous materials (chemicals, contaminated equipment, lead, PBC, paints)
Other:
Employee will transport biohazardous waste (chemical samples, human blood or tissue, animals,
contaminated equipment)
Other:
Employee will transport universal materials (ballasts, batteries, computers, fluorescent bulbs,
insecticides, mercury products)
Other:
Explain: