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<br /> <br /> <br /> <br />ADDENDUM TO JOB DESCRIPTION <br /> <br />Physical Requirements <br /> <br />Please check the level of frequency that best describes the physical demands that are required for you to perform your job duties. <br />Do not consider those parts of your job that, if you had a disability, a reasonable accommodation could be made. For example: If you <br />were in a wheelchair, but had to occasionally move a box of paper, it would be a reasonable accommodation to have someone else <br />move it for you. In that case, you would not consider moving the box as a required part of your job. <br /> <br />For each physical activity below, check the box that applies to your job. <br /> <br /> <br />Physical Activity <br />Frequency of Activity <br />Not Required Seldom Often Nearly Continuously <br />Sitting ☐ ☒ ☐ ☐ <br />Repetitive hand motion (such as typing) ☒ ☐ ☐ ☐ <br />Hearing, listening ☐ ☐ ☐ ☒ <br />Talking ☐ ☐ ☐ ☒ <br />Standing ☐ ☐ ☒ ☐ <br />Walking ☐ ☐ ☒ ☐ <br />Bending ☐ ☐ ☒ ☐ <br />Stooping ☐ ☐ ☒ ☐ <br />Climbing stairs ☐ ☒ ☐ ☐ <br />Climbing ladders ☐ ☒ ☐ ☐ <br />Kneeling, squatting ☐ ☐ ☒ ☐ <br />Crouching ☐ ☒ ☐ ☐ <br />Crawling ☐ ☒ ☐ ☐ <br />Balancing ☐ ☒ ☐ ☐ <br />Reaching overhead ☐ ☒ ☐ ☐ <br />Pulling, pushing ☐ ☐ ☒ ☐ <br />Shoveling ☐ ☐ ☒ ☐ <br />Lifting – up to 10 pounds ☐ ☐ ☒ ☐ <br />Lifting – up to 20 pounds ☐ ☐ ☒ ☐ <br />Lifting – up to 30 pounds ☐ ☐ ☒ ☐ <br />Lifting – up to 50 pounds ☐ ☒ ☐ ☐ <br />Lifting – over 50 pounds ☐ ☒ ☐ ☐ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />