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Application for Employment 1338 Rumsey Ave. PO Box 2200 CODY, WY 82414 (307) 527-7511 POSITION APPLIED FOR St Maint Operator IIATE OF APPLICATION / / 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] ---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 ---PAGE BREAK--- City of Cody Job Description Title: Street Maintenance Operator II Code: 472 Department: Public Works Effective Date: 03/2007 Division: Streets Last Revised: GENERAL PURPOSE Performs advanced level complex semiskilled, skilled or technical work in the operation of a variety of heavy equipment, machinery and tools used in the construction, maintenance and repair of City streets and property. Removes snow from streets, parking lots, sidewalks and bike paths; sands and salts as assigned. Drives trucks equipped with dump body to transport materials. Performs a variety of journey level skilled duties related the preparation, manufacturing and installation of signs and warning devices. Assists in the striping operations of the city roads and designated areas. SUPERVISION RECEIVED Works under general supervision of the Street Superintendent or Lead Street Maintenance Operator while in training or a project-by-project basis. SUPERVISION EXERCISED None ESSENTIAL FUNCTIONS Street Operations: Operates single axle and tandem axle dump trucks (with or without plow and sanders attached), front end loaders, graders, rollers, backhoes, other heavy equipment and welders and other tools for maintenance and repair operations. Checks and services assigned equipment; performs routine maintenance and emergency repairs as directed; reports mechanical problems for the shop to repair. Loads trucks by hand or by operating mechanical loader. Inspects truck equipment and supplies such as tires, lights, brakes, gas, oil and water. Participates in various field projects, i.e., cleaning alleyways, transporting road base, topsoil and road chips; assists in laying road chips and completing road resurfacing; completes concrete work as assigned. Performs related work within Streets and other departments as required; i.e., sanitation truck, recycle trailer, belly dump, etc. Traffic Control: Installs, maintains and repairs city signs and traffic control devices; operates paint truck, assists in striping of roads, shoulder stripes (fog lines), parking lots, curbs and designated areas; performs surveys to determine the need for traffic control devices, evaluate condition of existing devices, etc.; documents signing inspection detail and inventory needs. Performs general maintenance on paint truck and paint guns; rebuilds and cleans parts as needed to assure efficient operation. Fabricates and assembles street signs as directed determining the type, size and placement of letters on sign blanks; creates and uses stencils for painting applications. Performs installation of various types of signs and devices; selects posts, digs post holes using hand tools, power post hole digger or auger; mixes and pours concrete, sets posts. Performs preventative maintenance on equipment by checking oil and grease levels, etc., makes minor mechanical repairs as needed. Performs various field duties; assists engineers in setting traffic count devices; sets up work zones according to traffic control plans; conducts traffic field surveys, documents traffic direction, “kid counts”, pedestrian count, etc.; conducts “key counts” to determine intersection activity and travel times. Performs “clear zone” inspections to assure visual clearance for signs; trims trees and removes other obstructions to assure public safety. Sets temporary address posts on unoccupied property as needed to enable locations during emergency operations. ---PAGE BREAK--- Street Maintenance Operator II, page 2 Generally monitors road conditions for hazards; sets temporary or permanent hazard markers, signs and warnings. Operates various types of light and heavy equipment in as needed to assist other departments or complete specialized projects, i.e., tree trimming, sweeper, skid loader, dump truck, etc. Performs related duties as required. MINIMUM QUALIFICATIONS 1. Education and Experience: A. Graduation from high school, or GED; AND B. Two years of progressively responsible experience in a field directly related to above duties; OR C. An equivalent combination of education and experience. 2. Knowledge, Skills and Abilities: Working knowledge of drawings and specifications, grades, machinery, materials, and methods of constructing roads, bridges, drainage systems, culverts, etc.; heavy equipment operating principles; safety standards related to road construction; hazards and safety precautions common to heavy equipment operations; equipment maintenance and repair; legal liabilities associated with street construction and maintenance; basic civil engineering standards related to street construction and drainage; federal regulations, Manual on Uniform Traffic Control Devices (MUTCD), governing the design, installation and location of highway and warning signs; methods and processes related to sign and stripe painting. right-of-way laws and ordinances; basic computer operations and various software applications. Some knowledge of minor equipment maintenance and repair functions Journey level Skill in the operation of heavy equipment of various types under varying conditions. Skill in the use of various small power and hand tools, i.e., trowel, edger, grinder, pipe wrench, drills, cutting torch, pressure washer, etc. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals; read and comprehend grade stakes, construction maps and drawings and other work related documents; operate heavy equipment of various kinds under varying conditions; make minor repairs on assigned vehicles, perform heavy physical labor; add, subtract, multiply, divide in all units of measure, using whole numbers, common fractions, and decimals; develop and maintain effective working relationships with co-workers, elected officials, local agencies and the general public; write routine reports and correspondence; communicate effectively, both verbally and in writing; work from blueprints; tolerate weather extremes in the work environment. 3. Special Qualifications: Must possess a valid Wyoming Class A Commercial Driver’s License, with required endorsements, which may include double and triple trailers, hazardous materials and tank vehicles. May be required to become HAZMAT certified. May be required to become certified as a technician by International Municipal Signal Association (IMSA) Must be on the on call schedule and live within a 20 minute response time. Subject to shift changes and modifications. 4. Work Environment: Tasks require variety of physical activities, generally involving muscular strain, related to walking, standing, stooping, sitting, reaching and lifting. Talking, hearing and seeing essential to performing required job functions. Common eye, hand, finger dexterity is required. Mental application utilizes memory for details, verbal instructions, emotional stability and discriminating thinking. Daily local travel required in normal course of job performance. Employee is regularly exposed to moving mechanical parts and outside weather conditions. The employee is frequently exposed to fumes or airborne particles and vibration. The employee is occasionally exposed to wet and/or humid conditions; high, precarious places; extreme cold; extreme heat; and risk of electrical shock. The employee is often exposed to toxic or caustic chemicals including fuels, paints, solvents, herbicides, pesticides, fertilizers, oils, asphalts and other construction materials that may be of high temperatures. The noise level in the work environment is moderate to loud with extensive exposure to heavy equipment sounds.