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 hearing required / FBI check/fingerprinting / Restricted access
Baseline evaluation of vision required / Fumes, dust, others / Powered industrial vehicle (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 Select2526 to 5051 to 100101 to 150151 or more lbs / Security / Respirator use
Plant/Facility maintenance / Physical exertion / Custodial duties
DOT shipping/receiving of hazardous, biological or infectious materials / Grounds (lawn maintenance)
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 / Respiratory protection
Hard hat / Protective eyewear / Safety shoes
Hearing protection
Other:
Ergonomic Concerns
Select the activities required to perform the job:
Balance / Crouch / Reach
Bend/Stoop / Keyboard/Type / Reach above shoulder
Climb ladders / Kneel / Repetitive motion
Climb stairs / Squat / Use computer mouse
Crawl / Push/Pull
Explain:
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: