Dishwasher Utility Worker Page 5

Communicating by writing/reading

Distinguishing odors by smell

Distinguishing tastes

Exposure to wild/dangerous animals

Exposure to insect bites or stings

Work/travel in boat/small aircraft

Exposure to aggressive/angry people

Restraining/grappling with people

Other:

Items checked above must be consistent with tasks listed.

Are there any other physical or mental requirements of this position

not addressed above?

I have read and understand the physical requirements and potential hazards of this

position and am able to perform the physical requirements as stated above with or

without reasonable accommodation.

Employee Signature

Date

FWPDA Dishwasher

Revised 3-8-2016

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Parent category: Business