Enclosure (3) to COMDTINST 12630.1
5. Are file cabinets and storage closets arranged so
drawers and doors do not open into walkways?
Yes
No
6. Do chairs have any loose casters (wheels) and are
chair legs sturdy?
Yes
No
7. Are the phone lines, electrical cords, and
extension wires secured under a desk or
along a baseboard?
Yes
No
8. Is the office space neat, clear, and free of excessive
amounts of combustibles?
Yes
No
9. Are floor surfaces (including carpets) clean, dry,
level, and free of worn or frayed seams?
Yes
No
10. Is there enough light to read?
Yes
No
11. Is the residence equipped with working smoke
Yes
No
COMPUTER WORKSTATION (IF APPLICABLE)
12. Is your chair adjustable?
Yes
No
13. Does a back rest support your back
adequately?
Yes
No
14. Is your computer monitor at eye level?
Yes
No
15. When keying, are your forearms close to parallel
with the floor? Are your wrists fairly straight?
Employee Signature__________________________ Date_________________
Please attach a copy of this list to your Telecommuting Agreement and retain a copy for your
records.
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