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Application for Employment 1338 Rumsey Ave. PO Box 2200 CODY, WY 82414 (307) 527-7511 POSITION APPLIED FOR Apprentice Electric Lineman I DATE NAME LAST FIRST MIDDLE LIST OTHER NAMES USED, IF MAILING ADDRESS STREET OR PO BOX CITY STATE ZIP CODE PRIMARY TELEPHONE NUMBER ( ) - ALTERNATE TELEPHONE NUMBER EMAIL Are you under the age of 14? YES NO Are you over the age of 18? YES NO (For Police Officers in WY, the minimum age is 21) Have you ever been employed by the City of Cody? YES NO If yes, give dates I understand, if hired, I will be required to provide proof of eligibility to work in the United States. YES NO Have you ever been convicted of any law violation other than a minor traffic violation? YES NO (“YES” answer does not automatically disqualify you from employment since the nature of the offense, date and the job for which you are applying will also be considered.) If yes, give details: Are you related to anyone presently working for the City of Cody? YES NO If Yes, list name Do you have a valid license? YES NO Driver’s License # STATE? Do you have a Commercial Driver’s License? YES NO Class: (A,B,C) Endorsements Held: Hazardous Material Tanker Airbrakes Passenger Have you ever been terminated, dismissed or asked to resign from any position? YES NO If yes, please explain Educational Background COLLEGE/UNIVERSITY/TRADE SCHOOLS CITY/STATE CREDITS COMPLETED DEGREE/ DIPLOMA YEAR MAJOR MINOR High School: City Website: http://www.cityofcody-wy.gov Email:[EMAIL REDACTED] Five Year Driving Record Required to be submitted with application if NO must be able to obtain within six months of hire date ---PAGE BREAK--- Employment History List your employment history starting with the most recent employer. List all positions held, including military experience, part-time, summer and/or volunteer work and periods of unemployment. Explain any gaps in employment in comments section below. EMPLOYER TELEPHONE ( ) - DATES EMPLOYED Summarize your job responsibilities FROM TO ADDRESS JOB TITLE SALARY FINAL IMMEDIATE SUPERVISOR AND TITLE $ PER HOUR PER WEEK PER MONTH REASON FOR LEAVING MAY WE CONTACT? EMPLOYER TELEPHONE ( ) - DATES EMPLOYED Summarize your job responsibilities FROM TO ADDRESS JOB TITLE SALARY FINAL IMMEDIATE SUPERVISOR AND TITLE $ PER HOUR PER WEEK PER MONTH REASON FOR LEAVING MAY WE CONTACT? EMPLOYER TELEPHONE ( ) - DATES EMPLOYED Summarize your job responsibilities FROM TO ADDRESS JOB TITLE SALARY FINAL IMMEDIATE SUPERVISOR AND TITLE $ PER HOUR PER WEEK PER MONTH REASON FOR LEAVING MAY WE CONTACT? Additional job history and/or resume can be attached. EXPLAIN GAPS IN EMPLOYMENT: SPECIAL SKILLS AND QUALIFICATIONS: Summarize special skills and qualifications you would like us to consider including certifications and licenses. Professional References List three (non-related) persons who can objectively assess your professional or scholastic performance. NAME TELEPHONE YEARS KNOWN ---PAGE BREAK--- CERTIFICATION OF ACCURACY & AUTHORIZATION TO RELEASE INFORMATION I certify that all information provided in this application is true and complete. I understand misrepresentation or omission of facts during the application or selection process may disqualify me from further consideration and may be cause for dismissal. I understand the City of Cody may conduct a background investigation, which may include obtaining information as to my character, reputation, and mode of living. This may include interviews with my relatives, neighbors, friends, former employers, schools and others. I authorize the City of Cody to investigate my employment background and personal history. I authorize the City of Cody to obtain any and all information relevant to determining my qualifications for the job for which I have applied. I further authorize the City of Cody to obtain copies of and review any and all employment records, documents and such other information as the City of Cody may determine relevant to its investigation. I agree to sign an authorization and consent to release of information to allow the City of Cody to obtain copies of prior employment records, documents and information from prior employers, organizations, references, and individuals who may have information relevant to my qualifications to work for the City of Cody. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I understand that I may also be required to successfully pass drug and alcohol screening examinations. I hereby consent to pre- and/or post-employment drug and alcohol screens as a condition of employment, if required. I have read, understand, and by my signature, consent to these statements. I authorize investigation of all information contained in this application. Signature of Applicant Date Must obtain and maintain a class A CDL or able to obtain within six months of hire date. FIVE YEAR DRIVING RECORD MUST BE SUBMITTED WITH APPLICATION - FROM ANY STATE DRIVING LICENSE WAS VALID IN DURING THE FIVE YEAR PERIOD. ---PAGE BREAK--- City of Cody Job Description Title: Apprentice Electric Lineman I Code: 422 Department: Electric Effective Date: 03/2007 Division: Operations Last Revised: GENERAL PURPOSE Performs a variety of apprentice entry level, technical duties related to performing and effecting power system installation, distribution, transmission and maintenance. SUPERVISION RECEIVED Works under the close supervision of the Lead Lineman or Electrical Superintendent. SUPERVISION EXERCISED None. ESSENTIAL FUNCTIONS Conducts general technical analysis of line functions and operations as needed to anticipate and prevent line problems; makes recommendations for line specifications on new construction and circuit enhancements; prepares routine reports of activities; uses various equipment, tools and vehicles in maintaining an electrical distribution system to assure against loss of service. Assists in construction, installation, maintenance and repair of substations, and circuits for overhead and underground power lines; digs trenches and lays pipe for underground lines; assists in building new substations and maintains existing substations. Assists connecting, installing, maintaining and repairing energized overhead and underground power distribution and transmission lines; operates line trucks, line working apparatus and heavy equipment; digs pole holes and trenches, sets and frames poles; climbs poles, descends into vaults or trenches; strings lines; splices and sags wire on live or dead circuits; connects or disconnects transformers, cutouts, meters and guide wires, changes insulators on high voltage lines and taps into transmission lines; makes URD splicing and terminations; locates damaged lines and poles; troubleshoots power distribution equipment to determine problems; splices cables; repairs, sets and terminates transformers; conducts voltage and amperage checks and system tests ; replaces fixtures in crossarms; hangs insulators; replaces and repairs fuses, grounds, etc. Responds to emergency calls, resolves power problems and restores power outages; makes connections and disconnections for customers; informs public of pending outages due to repair; repairs street lights, trims trees and removes other line obstructions; explains problems to public; requests cooperation during repair; uses various technical tools including crimpers, hot sticks, cutters, body belts, bucket truck, wire pullers, etc. Assists to maintain inventory of instruments, meters, instrument transformers and related equipment, materials and supplies. Assists in performing a variety of maintenance testing, calibration and repair on electrical instruments including single phase, watt hour and demand meters, recording volt and amp meters, transformers, etc., used in electrical utility programs for testing equipment; tests and maintains equipment; determines cause of meter malfunction. Tests personal protective equipment used in high voltage work, including rubber gloves, etc.; installs and services City street lights. ---PAGE BREAK--- Apprentice Electric Lineman I, page 2 Assists in performing miscellaneous duties affecting the overall delivery and quality of power services; including, line locations for underground system; pulls wire; completes termination’s and performs shut- off's, utilizes rubber gloving methods; prepares rigging for poles; assists with electrical and GFI inspections; performs substation readings; performs permanent power and temporary power connections; responds to power outages; services power plant, checking oil levels, battery water levels and output. Operates chipper; performs routine service on all trucks; performs tree trimming; operates backhoe, boom trucks, dump truck, etc. Performs all other duties as assigned. MINIMUM QUALIFICATIONS 1. Education and Experience: A. Graduation from high school or GED. AND B. Less than one year of experience performing above and related duties; OR C. An equivalent combination of education and experience. 2. Knowledge, Skills, and Abilities: Some knowledge of basic understanding of electricity; common safety practices associated with high voltage environments; methods of operating equipment enabling the acquisition of a Wyoming class commercial drivers license. Must demonstrate progressive apprentice skill during on-the-job training in the use of various types of heavy equipment, hand and power tools crimpers, i.e., hot sticks, cutters, body belts, bucket truck, line truck, wire pullers, digger derrick, power saw, wood chipper, etc. Ability to read and comprehend documents such as safety rules, operating and maintenance manuals and instruction, and procedure manuals; write routine reports and correspondence; speak effectively to supervisors, members of the general public and City employees; apply common sense understanding to carry out instructions furnished in written, oral or diagram form; address problems, which may involve multiple variables. 3. Special Qualifications: Must become a certified journeyman power lineman from an accredited apprenticeship program within four years of hire. Must possess and maintain a valid Wyoming class Commercial Drivers License (CDL). Must maintain annual continuing education requirements related to licenses and certifications. Must be CPR certified. Must be on the on-call schedule and live within a 20 minute response time. 4. Work Environment: Incumbents of the position perform normally in an outdoor, physical environment. Tasks require variety of physical activities involving muscular strain, related to walking, standing, stooping, sitting, reaching and lifting. Essential functions require talking, hearing and seeing. Common and complex eye, hand, finger dexterity exist. Mental application utilizes memory for details, verbal instructions, emotional stability, discriminating thinking and creative problem solving. Daily travel required in normal course of job performance. Regular exposure to changing weather conditions and hazards common to high voltage power system. Disclaimer: The above statements describe the general nature, level, and type of work performed by the incumbent(s) assigned to this classification. They are not intended to be an exhaustive list of all responsibilities, demands, and skills required of personnel so classified. Job descriptions are not intended to and do not imply or create any employment, compensation, or contract rights to any person or persons. Management reserves the right to add, delete, or modify any and/or all provisions of this description at any time as needed without notice. This job description supersedes earlier versions. I have reviewed the above job description. (Employee)