Title Page

  • Document No.

  • Conducted on

  • Names of persons carrying out the assessment.

  • Location of task being assessed I.e. Factory/department.

  • Description of task

  • no label
  • Activity/load weight (kg)

  • Weight of load.

  • Weight of load.

  • Weight of load.

  • Posture assessment.

  • no label
  • Hand grip

  • no label
  • Work pattern

  • no label
  • Travel distance

  • no label
  • Floor surface

  • no label
  • Obstacles along the route

  • no label
  • Other factors.

  • no label
  • Take a photo of the task.

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