ORS 4PPD 4G Occupational Requirements Survey

U.S. Department of Labor Bureau of Labor Statistics

Occupational Requirements Survey

State and local government

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PRINT ADDITIONAL COPIES OF PAGES 2-4, AS NEEDED.

Schedule/Quote: ___________ Work Schedule: ____________

Job Title		Work Schedule		Job Description (Y/N)	FT/PT
Job Observation (circle):		Yes - requested	Yes - offered		No
Critical Job Function:

Task List:	Minimum Education
	Experience
	Credentials
	On the Job Training
10% Tasks:	Driving (yes/no) Vehicle Type?
	Supervisory Data:
	Lead/Supervisor/Manager/None
	Work Checked: (more than 1x/day, 1x/day, At least 1x/week, less than weekly)
	Supervisor Present? Y/N

Work-Related Communication:
Verbal Interactions (every few min, more than 1x/hour, more than 1x/day, once per day or less)
Speaking (duration)
People Skills (basic, more than basic)
General Public? Y/N		Crowds? Y/N			Telework? Y/N
Job Title			Work Schedule
Hearing: In-Person Speech? Y/N Telephone? Y/N Other Remote Speech? Y/N Other Sounds? Y/N
Noise Intensity Level (quiet, moderate, loud, very loud) PPE? Y/N
Cognitive:
Control of Work Load? (machinery/equip/software, numerical perf. target, people, self-paced, other)
Work Pace? (consistent-fast, consistent-slow, varies)
Ability to step away? Y/N
Problem Solving? (more than 1x/day, 1x/day, at least 1x/week, at least 1x/month, less than 1x/month)

Sit/Stand/Walk		Duration	Other		Notes
Sitting
Standing/Walking
Sitting/Standing at Will			Y/N
Lift/Carry (breaks at 1/10/25/50/75/100 lbs)
Most weight ever
2/3 of the time or more
1/3 up to 2/3 of the time
2% up to 1/3 of the time
Seldom (up to 2%)
Pushing/Pulling
Hands/Arms			One/Both
Feet/Legs			One/Both
Reaching/Manipulation
Overhead Reaching			One/Both
At/Below Shoulder Reaching			One/Both
Gross Manipulation			One/Both
Fine Manipulation			One/Both
Foot/Leg Controls			One/Both
Traditional Keyboarding
Postural
Work at or below knee level			Y/N/Unk
Stooping			Reqd/Choice/No/Unk
Kneeling			Reqd/Choice/No/Unk
Crouching			Reqd/Choice/No/Unk
Crawling			Reqd/Choice/No/Unk
Job Title				Work Schedule
Postural – Climbing		Duration	Other		Notes
Ramps or Stairs, Structural			Y/N
Ramps or Stairs, Work-related
Ladders, Ropes, or Scaffolds
High, Exposed Places			Y/N PPE
Vision
Near Visual Acuity			Y/N
Far Visual Acuity			Y/N
Peripheral Vision			Y/N
Environmental Conditions
Outdoors
Extreme Heat
Extreme Cold
Wetness
Humidity
Heavy Vibration
Hazardous Contaminants			Y/N PPE
Proximity to Moving Mechanical Parts			Y/N PPE

ORS Form 4 PPD-4G