Attachment D ORS Form

ORS Form 4 PPD-4P

U.S. Department of Labor
Bureau of Labor Statistics

Occupational Requirements
Survey

Private Industry
The Bureau of Labor Statistics, its employees, agents, and
This report is authorized by law, 31 United States Code §§ 1535/FAR
partner statistical agencies, will use the information you
O.M.B. #1220-0189
17.5 of the Economy Act. Your voluntary cooperation is needed to
provide for statistical purposes only and will hold the
Expires 08/31/18
make the results of this survey comprehensive, accurate and timely.
information in confidence to the full extent permitted by law.
In accordance with the Confidential Information Protection
and Statistical Efficiency Act of 2002 (Title 5 of Public Law
107-347) and other applicable Federal laws, your responses
will not be disclosed in identifiable form without your
informed consent.
We estimate that it will take an average of 66 minutes to complete this form, including time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing this information. If you have any comments regarding this estimate or any other aspect of this
survey including suggestions for reducing this burden, please send them to the Bureau of Labor Statistics, Office of Compensation and Working Conditions (12200189), 2 Massachusetts Avenue N.E., Washington, D.C. 20212. You are not required to respond to the collection of information unless it displays a currently valid
OMB control number.

Schedule number:
Total Employment:

Start:
End:
PSO Employment:

Selected Occupations

Occ. Emp. FT/PT

U/N

T/I

SOC

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PRINT ADDITIONAL COPIES OF PAGES 2-5, AS NEEDED.

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Quote: ____________

Quote Details
Job Title:
Job Observation (circle):

Schedule: ____________

Yes - requested

Job Tasks/Notes
Driving:

□Yes □No

Job Description: (Y/N)
Yes - offered

No

SVP
Minimum Education
Minimum formal education required? If no
minimum, must workers be able to read and write?

Vehicle Type (if yes): ___________________

Pre-Employment Training
Professional certification, state or industry license,
other pre-employment training required? Type and
time to obtain?

Experience
Prior work experience required? How much?

Post-Employment Training
Post-employment training (OJT, mentoring, etc.)
required? Type and how much?

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Quote: ____________

Schedule: ____________

Cognitive Elements
What type of decision-making is required to perform the tasks of this occupation?
 (A) Little or no decision-making.
 (B) Makes straightforward decisions from set choices in familiar situations.
 (C) Makes straightforward decisions by assessing situations and possible outcomes.
 (D) Makes decisions by assessing uncertain or conflicting situations.
What type of supervision does this occupation have?
 (A) Detailed instruction and help are always provided. Frequent and thorough
review of work.
 (B) Detailed instruction and help are provided when needed. Review of work may be
frequent and emphasize the quality of completed assignments.
 (C) General instructions provided and help given when requested. Review of work is
occasional and emphasizes accomplishments of broad work objectives.
 (D) Only broad objectives are provided. Review of work is infrequent and focuses
on effectiveness.
What is the pace of the work?
 Slow: Unhurried and workload is constant.
 Moderate: Steady and workload is constant.
 Fast: Rapid and workload is constant.
 Variable: Markedly faster and slower periods that are driven by changing workload demands.
What controls the pace of the work?
 Work-driven: Work process drives the pace; the worker must keep up and continuously
meet production standards.
 Worker-driven: Worker controls the pace.

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Quote: ____________

Schedule: ____________

Adaptability
An occupation’s work routine consists of its work tasks, work schedule, and location of work as it is generally
performed. We are interested in how frequently work tasks, schedule, and location change. Select the statement
that best describes how frequently the work routine changes for this occupation.
How often do (work tasks/schedule/location) change in this occupation?

Work
tasks

Work
Work
schedule location

A - Rarely or never changes
Does not change unless it is permanent.
B – Sometimes changes
May temporarily change several times a year to meet business needs including
seasonal variations.
C – Often changes
Changes on an unpredictable basis to meet business needs.
D – Always changes
Change is frequent and driven by forces external to the company, such as
emergency response.
Work Related Personal Interactions
Regular Contacts: People with whom there is an established working relationship.
Other Contacts: People with whom there is no established working relationship.
How often does the occupation verbally interact (work related) with:

Regular
Contacts

Other
Contacts

Regular
Contacts

Other
Contacts

Ongoing (Constantly, every few minutes)
Several times an hour (More than once per hour, but not constantly)
Hourly or Semi-Hourly (More than once per day, but not more than once per hour)
Daily or Less (No more than once per day; includes never)

What type of work-related interactions does this occupation have with:
Very structured (Exchanging straightforward, factual information)
Structured (Coordinating work with others; solving recurring problems
with cooperative parties)
Semi-structured (Some gentle persuading or soft-selling; discussing)
Unstructured (Influencing; hard-selling; asserting control in situations)
Very unstructured (Resolving controversial or long-range issues; defending;
negotiating)

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Quote: ______________

Exertion
Sit/Stand/Walk
Standing and Walking
Sitting
Sitting vs. Standing at Will
Lifting/Carrying (lbs.)
Most weight ever
2/3 of the time or more
1/3 up to 2/3 of the time
2% up to to 1/3 of the time
Seldom (up to 2%)
Pushing/Pulling
Hands/Arms
Feet/Legs
Feet Only
Reaching/Manipulation
Overhead Reaching
At/Below Shoulder Reaching
Gross Manipulation
Fine Manipulation
Foot/Leg Controls
Keyboarding
Traditional
10-Key
Touch
Other (document)
Postural
Stooping
Kneeling
Crouching
Crawling
Climbing Ramps or Stairs
Structure only (non-work related)
Work-related time
Climbing Ladders, Ropes, or Scaffolds
Auditory/Vision
Communicating Verbally
Hearing Requirements
One-on-one
Group
Telephone
Other Sounds
Passage of a Hearing Test
Near Visual Acuity
Far Visual Acuity
Peripheral Vision

Work Schedule: _____________

Schedule: _____________

Y/N

One/Both
One/Both
One/Both
One/Both
One/Both
One/Both
One/Both
One/Both

Y/N

Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N

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Schedule: ____________

Selected Occupation

Environmental Conditions
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PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

PPE

Outdoors
Extreme Heat (non-weather related)
Extreme Cold (non-weather related)
Wetness (non-weather related)
Humidity (non-weather related)
Heavy Vibration
Hazardous Contaminants*
(Toxic, Caustic Chemicals; Fumes; Noxious Odors; Dusts)
Proximity to Moving Mechanical Parts*

High, Exposed Places*

Noise Intensity Level*
(Quiet, Moderately Loud, Loud, Very Loud)
*Circle PPE if personal protective equipment is present.

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