JOB DESCRIPTION FOR WATER TRUCK DRIVER LICENSE REQUIREMENTS: Applicant must possess either a Class A or B COL with tank endorsement. Applicant must also have a current medical qualification certificate. OTHER REQUIREMENTS: Be able to read and write in the English language and understand and communicate verbally in English. Possess a good work ethic. Be honest and dependable. Have at least two years verifiable driving experience. Must meet guidelines of insurance underwriters and Knowles Enterprises pertaining to violations on Motor Vehicle Record. DUTIES AND EXPECTATIONS: DRIVE COMMERCIAL VEHICLES SAFELY, IN CONDITIONS THAT VARY FROM INTERSTATE HIGHWAY TO NARROW AND STEEP MOUNTAIN ROADS, IN ALL WEATHER CONDITIONS BE CAPABLE OF COMPLETING ALL REQUIRED PAPERWORK LEGIBLY BE CAPABLE OF REPEATEDLY LIFTING HEAVY OBJECTS SUCH AS TIRE CHAINS(7SLBS.) BE CAPABLE OF CLIMBING STEEP STAIRWAYS SEVERAL TIMES PER SHIFT BE CAPABLE OF FOLLOWING WRITIEN AND VERBAL DIRECTIONS BE CAPABLE OF WORKING IN A WIDE RANGE OF WEATHER FROM HOT (100 DEGREES) TO VERY COLD(BELOW ZERO) BE CAPABLE OF USING SIMPLE MATHEMATICS (ADDITION,SUBTRACTION,DIVISION AND MULTIPLICATION) TO COMPUTE LEVELS OF FLUIDS IN TANKS AND BARRELS IN LOAD BE CAPABLE OF IDENTIFYING POSSIBLE DEFFECTS ON TRUCK(KNOWLEDGE OF FEDERAL MOTOR CARRIER REGULATIONS PERTAINING TO VEHICLE INSPECTIONS) BE PHYSICALLY ABLE TO ENDURE EXTENDED PERIODS OPERATING TRUCK OVER ROUGH AND BUMPY ROADS IN REMOTE LOCATIONS. BE CAPABLE OF WORKING AT ELEVATIONS APPROACHING 10,000 FEET
KNOWLES ENTERPRISES Post Office Box 41017 Grand Junction, Co. 81504 The following is a list of helpful requirements by the DOT when you fill out and complete your application: 1. Please fill in all spaces and lines-if something does not apply-just write "NA" or "NONE". 2. We need 10 years of employment history-whether driving or not. It is required for a driving position by the DOT. 3. Please make sure you complete the Driving Experience pages. 4. Please make sure the last two pages are read and signed. 5. In the Employment History Sections MAKE SURE you fill in complete addresses of your past employers and the phone numbers. 6. Please be sure to attach a current (30-60 Days) Motor Vehicle Report (MVR) to your application when you return it to us. It must be with the application in order to be scheduled for an interview. Thank you very much for your compliance with the above. We look forward to seeing you soon. Bobby Knowles Safety Coordinator
APPLICATION FOR QUALIFICATION KNOWLES ENTERPRISES, LLC P.O. Box 41017 Grand Junction, CO 81504 The purpose of this application is to determine whether or not the applicant is qualified to operate motor carrier equipment according to the requirements of the Federal Motor Carrier Safety Regulations and the Company named above. Instructions to Applicant Please answer all questions. If the answer to any question is ''NO" or "NONE", do not leave the item blank, but write "NO" or "NONE". Date Position applying for Name -------------------------------- Home Nwnber Emergency Phone Number Cell Nwnber ------------ *Age Date of Birth~ Social Security Nwnber *The age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age. Physical Exam Expiration Date Current and Three Years Previous es: ---------------------- ----- ---- ---------------------- ----- ---- - --------------------- ----- ---- ---------- ------------ ----- ---- Have you worked for this company before? Yes If yes, give dates: Reason for leaving? NO
Education History Please circle the highest grade completed: Employment History Grade School: 1 2 3 4 5 6 7 8 9 10 11 12 College: 1 2 3 4 Post-Graduate: 1 2 3 4 Give a Complete Record of all employment for the past ten years, including any unemployment or self employment, and all commercial driving experience for the past ten years. Present or Last Employer ------ -------- ------------------ ------------------------------- Reason For Leaving Phone ----------- Were you subject to the FMCSR's* while employed here? Yes No ------ subject to the drug and alcohol testing requirements of 49 CFR Part 40? Y es NO Present or Last Employer ---------- ------- ----------------- ------------------------------ Reason For Leaving Phone Were you subject to the FMCSR's* while employed here? Yes No subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes NO_ *The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone who operates a motor vehicle on a hlghway in interstate commerce to transport passengers or property when the vehlcle: (1) bas a GVWR or weighs 10,001 pounds or more, (2) is designed or used to transport nine or more passengers, or (3) is of any size, used to transport hazardous materials in a quantity requiring placarding.
Reason For Leaving Phone --------- Were you subject to the FMCSR's* while employed here? Yes No ----- subject to the drug and alcohol testing requirements of 49 CFR Part 40? Y es NO Present or Last Employer ----- ----- --------- ---------------- Reason For Leaving Phone Were you subject to the FMCSR's* while employed here? Yes No subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes NO Present or Last Employer ---------- --------- ---------------- Reason For Leaving Phone Were you subject to the FMCSR's* while employed here? Yes No subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes NO_ *The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone who operates a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) has a GVWR or weighs 10,001 pounds or more, (2) is designed or used to transport nine or more passengers, or (3) is of any size, used to transport hazardous materials in a quantity requiring placarding.
Reason For Leaving Phone Were you subject to the FMCSR's* while employed here? Yes No ----- subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes NO_ Present or Last Employer --------- ---------------- Reason For Leaving Phone --------- Were you subject to the FMCSR's* while employed here? Yes No ----- subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes NO_ Present or Last Employer _ --------~ ---------------- Reason For Leaving Phone Were you subject to the FMCSR's* while employed here? Yes --------- No subject to the drug and alcohol testing requirements of 49 CFR Part 40? Y es NO_
Present or Last Employer ----- ----- --------- ---------------- Reason For Leaving Phone --------- Were you subject to the FMCSR's* while employed here? Yes No subject to the drug and alcohol testing requirements of 49 CFR Part 40? Y es NO _ Present or Last Employer ---------------------- --------- ---------------- Reason For Leaving Phone Were you subject to the FMCSR's* while employed here? Yes No ----- subject to the drug and alcohol testing requirements of 49 CFR Part 40? Y es NO _ Have you ever served in the Armed Forces? Yes --- No ----- If yes, How long did you serve '------- -------- Were you honorably discharged? Yes ---- No ------ If no, what was the reason you were separated from the Service?
Driving Experience Class of Equipment Straight Truck Dates Approximate Nwnber of Miles (tal) Tractor and Semi-trailer Tractor-two trailers Tractor-three trailers (triples) Other List states operated in, for the last five years: List special courses/training competed (PTD/DDC, Haz Mat, etc.): List any Safe Driving Awards you hold and from whom: Accident Record for past three years (attach sheet if more space is needed) Nature of Accidents #of #of Date of Accident (Head on, rear end, upset, etc.) Location of Accident Fatalities Injured Traffic Convictions and Forfeitures for the last three years (other than parking violations) Date Location Charge Penalty
Driver's License Qist each driver's license held in the past three years) State License# Type Endorsements Expiration Date A. Have you ever been denied a license, permit or privilege to operate a motor vehicle? YES NO B. Has any license, permit or privilege ever been suspended or revoked? YES NO C. Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the job description)? YES NO D. Have you ever been convicted of a felony? YES NO If the answer to A, B, C or Dis "YES", give details Personal References List three persons for references, other than family members, who have knowledge of your safety habits.
Be Read and Signed by Applicant It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty. It is agreed and understood that the motor carrier or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information. It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigation Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. I agree to furnish such additional information and complete such examinations as may be required to complete my application file. It is agreed and understood that this Application for Qualification in no way obligates the motor carrier to employ or hire the applicant. It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. Applicant Signature _ Date --------
Knowles Enterprises, LLC requires all employees to take a UA drug screen upon hiring. Knowles will pay for drug screening unless you are terminated or quit within the first six (6) months of hire date. This fee of Fifty Dollars ($50) will be taken out of your final check. Signature Date