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Application for Employment 1338 Rumsey Ave. PO Box 2200 CODY, WY 82414 (307) 527-7511 POSITION APPLIED FOR __RPT Water Operator I_ DATE 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] 5 year driving record must be submitted with application ---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 Five Year Driving Record must be submitted with application ---PAGE BREAK--- City of Cody Job Description Title: RPT Water Operator I Code: 489 Department: Public Works Effective Date: 03/2007 Division: Water Last Revised: GENERAL PURPOSE Performs a variety of entry level skilled duties related to the construction, installation, maintenance and repair of city water service systems including culinary water transmission and distribution, and pressurized irrigation. SUPERVISION RECEIVED Works under general supervision of the Water Systems, Sanitation & Public Transportation Superintendent. SUPERVISION EXERCISED None ESSENTIAL FUNCTIONS (Performs Some Or All Of The Following) Water: Operates backhoe and trenching equipment at the entry level apprentice level of skill; performs excavation, assists with the installation or repair of water service connections, water lines and meters, repairs or replaces fire hydrants and plugged water meters; repairs water mains; cleans and maintains storage tanks; power flushes lines; conducts water sampling; may inspect and read residential and commercial water meters. Assists in the maintenance and monitors pressure regulation valves; installs new water lines, meter boxes, raise and lower existing meter boxes as needed. Operates a variety of hand tools and small power equipment such as jack hammers, roller, compressors, packing machine, threading machine, tapping machine and tampers; cleans tools and equipment to assure proper working order. Participates in work zone safety procedures; flags on coming vehicles to protect the public and workers; sets up warning signs and signalization equipment. Locates and marks water mains and services; assists in leak repairs; assists in placement of pipe. Pressurized Irrigation: Assists with Performing pressurized irrigation pipe installation, maintenance and repairs; installs new mains; taps mains and installs service connections; repairs leaks in pressurized system. Monitors SCADA system and adjusts flows to prevent distribution problems; monitors and maintains raw water pumps and pump houses; repairs motors, ensures proper valve operations. Line Locator: Operates electronic and/or magnetic line locating equipment (metrotech); assists contractors, property owners, etc. as needed to prevent line damage. Performs other related duties as required. MINIMUM QUALIFICATIONS 1. Education and Experience: A. Graduation from high school or GED; AND B. One year experience in public works or general construction industry; OR ---PAGE BREAK--- C. An equivalent combination of education and experience. Water Operator I, page 2 2. Knowledge, Skills, and Abilities: Some knowledge of operating basic manual and power tools; the standard practices, methods, materials and tools necessary for pipe line construction and repair activities; pipe fitting procedures; the occupational hazards and safety precautions of trench work construction and pipeline maintenance work; hazards common to heavy equipment operation; interpersonal communication skills. Ability to operate heavy equipment of various kinds under varying conditions; perform heavy physical labor; develop and maintain effective working relationships with co-workers, elected officials, local agencies and the general public; communicate effectively, both verbally and in writing; work from blueprints; tolerate weather extremes in the work environment; ability to perform basic mathematical computations in reading and using various meters, gauges and related devices. 3. Special Qualifications: Must become a certified flagger. Must be Level I Water Operator or Level II Distribution Certified by the Wyoming Department of Environmental Quality. Must possess and maintain a valid class commercial driver’s license with tanker endorsement. Must be able to lift 50-75 pounds. Must become confined space/ Trench Safety (Competent Person) certified. Must be on the on-call schedule and live within a 20 minute response time. 4. Work Environment: Tasks require variety of physical activities, generally involving muscular strain, such as walking, standing, stooping, sitting, reaching and lifting. Talking, hearing and seeing essential to performing required job functions. Common eye, hand, finger dexterity exist. Mental application utilizes memory for details, verbal instructions, emotional stability and discriminating thinking. Daily local travel required in normal course of job performance. The employee is frequently exposed to moving mechanical parts. The employee is occasionally exposed to wet and/or humid conditions; high, precarious places; fumes or airborne particles; toxic or caustic chemicals; extreme cold; extreme heat; risk of electrical shock; and vibration. The noise level in the work environment is usually moderate with general exposure to heavy equipment sounds. 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) Note as advertised – CDL obtainable within six months of hire and Level I Water Operator or Level II Distribution Certification within one year of hire Required to submit a 5 year driving record with application