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11 POSITION APPLIED FOR: Water Operator I, $17.04/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: 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 C. An equivalent combination of education and experience. ---PAGE BREAK--- 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)