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11 POSITION APPLIED FOR: Street Maintenance Operator I, $14.72/hr Date: Employment Application City of Cody P.O. Box 2200 ~ Cody, WY 82414 Name Last First Middle Street/Mailing Address: City St Zip Email Address: Work Phone: Home Phone: Cell Phone: List other names, if any, used on employment or education records: Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? □ Yes □ No Are you 18 yrs or older? □ Yes □ No Are you under the age of 14? □ Yes □ No For Temporary/Seasonal Hire – Please complete the following. Dates Available for Employment: From to Have you ever been convicted of a felony? □ Yes □ No If yes, describe in full detail, giving dates (Criminal convictions are not an absolute bar to employment, but will be considered in relation to specific job requirements.) Have you ever worked for or are you currently working for the City of Cody? □ Yes □ No If yes, please give dates and department(s): Prior Position(s): Reason(s) for leaving: Do you have any relatives working for the City of Cody? □ Yes □ No If yes, please give their name, department and relationship: P E R S O N A L I N F O R M A T I O N ---PAGE BREAK--- E D U C A T I O N School Name and Address of School Course Circle Last Year Did You List Diploma Of Study Completed Graduate or Degree(s) High 8 9 10 11 12 □ Yes □ No College 1 2 3 4 □ Yes □ No Other (Specify) S P E C I A L S K I L L S Special Skills Relating To The Position For Which You Are Applying: (clerical skills, heavy equipment operating skills, etc.) C E R T I F I C A T I O N S Driver’s License: If required for this position: Do you have a valid Driver’s License? □ Yes □ No State: License Number: Expiration Date: Do you have a Commercial Driver’s License? □Yes □ No If yes, specify: Class: B, C) Endorsements Held: Hazardous Material □ Tanker □ Airbrakes □ Passenger □ (Please check all that apply) Other (specify) Certificates: (CPA, PE, Boiler Operator, Life guard, etc) Name and address of Licensing Agency Type of License Endorsement/Restriction (if applicable) Date Licensed Date Expires (if applicable) ---PAGE BREAK--- E M P L O Y M E N T H I S T O R Y Employment Experience Instructions: Begin with your present or most recent job and list your entire work experience with emphasis on experience relevant to the position for which you are applying. Include military service and any volunteer work which provided experience that would help you qualify. If the space below is not adequate, you may continue this section on a separate sheet of paper. This information must be completed. Notice to Applicants: Information that you provide on this application is subject to verification. Previous employers may be contacted as references or for verification. Do you want to be informed before we contact your present employer? □ Yes □ No Current Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: 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 understand I have the right to make a written request within a reasonable time for the disclosure of the name and address of any consumer reporting agency which may be utilized in the background investigation so I may obtain a complete disclosure of the nature and scope of the investigation. I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations named in this application to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. 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 (Revised 2013) References: List three references, excluding relatives, who have knowledge of your ability to perform this job. Name of Reference Complete Mailing Address Telephone Number Years Acquainted ---PAGE BREAK--- Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: ---PAGE BREAK--- City of Cody Job Description Title: Street Maintenance Operator I Code: 473 Department: Public Works Effective Date: 03/2007 Division: Streets Last Revised: GENERAL PURPOSE Performs entry 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 apprentice 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. ---PAGE BREAK--- 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. 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. One year of experience in a field directly related to above duties; OR C. An equivalent combination of education and experience. 2. Knowledge, Skills and Abilities: Some knowledge of drawings and specifications, grades, machinery, materials, and methods of constructing roads, bridges, drainage systems, culverts, etc.; heavy equipment operating principles; basic principles of supervision and employee motivation; 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; right-of-way laws and ordinances; basic computer operations and various software applications; minor equipment maintenance and repair functions Apprentice 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 and the general public; 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 B Commercial Driver’s License. May be required to become HAZMAT certified. May be required to become certified as a technician by International Municipal Signal Association (IMSA) 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 ---PAGE BREAK--- 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.