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Placer County Human Resources Department
#2021-11307-01


Supplemental Questionnaire

Last Name First Name
 

 

UTILITY SERVICE WORKER

Supplemental Questionnaire


This supplemental questionnaire is the examination for this recruitment.

Please answer the following questions based on your job related training and experience. Based on your checked responses, your job-related experience will be scored and then ranked. Narratives provided by applicants describing experience will not be scored but will be available to the hiring authority and may be utilized for interview and selection determinations.

NOTE: Resumes, letters, and other materials will not be evaluated or considered as responses to the items in the supplement.

By continuing in this examination process, you are certifying that all information provided in the supplemental questionnaire is true to the best of your knowledge.


 

I have read and I understand the above information.

1.

Do you currently possess the following:

Valid Class A driver's license
Valid Class B driver's license
A certificate of training in use of self-contained breathing appartus
None of the above
2.

Please mark the building trades skills that you have experience in:

Carpentry
Plumbing
Electrical
Mechanical
Welding
None of the above
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

3.

Do you have experience locating, inspecting, and repairing manholes?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

4.

Do you have experience locating, testing for, and repairing leaks in sewer and water lines?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
5.

Do you have experience inspecting sewer and water lines manually and by television?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

6.

Do you have experience operating high pressure sewer line cleaning equipment to free plugged mains?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

7.

Do you have experience performing maintenance on sewer ponds and at landfill sites?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
8.

Do you have experience installing and repairing piping and valves?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

9.

Do you have experience cutting, threading, assembling, and laying pipe, and tapping main lines and making new service connections?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
10.

Do you have experience inspecting, maintaining, rebuilding, and repairing pumps and electric motors, controls, and alarms?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

11.

Do you have experience reading and repairing flow meters?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
12.

Do you have experience operating light and moderately heavy equipment such as dump trucks, boom trucks, and backhoes?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

13.

Do you have experience patching road pavement?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
14.

Do you have experience clearing, cleaning, and maintaining drainage ditches?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated any experience, please briefly describe. If you indicated no experience, please state "None".

15.

Do you have experience transporting, loading, and unloading equipment and supplies to worksites?

I have some experience performing these tasks but would need additional training.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
16.

Do you have experience performing traffic control, including flagging, setting up and removal of signs and cones?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
17.

Do you have experience interpreting manuals, schematics, plant diagrams, and drawings?

I have no or very limited experience in performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.

 

Thank you for completing the supplemental questionnaire portion of the application process. We encourage applicants to review their answers for accuracy prior to submitting.

Please Save & Continue to move forward to the next tab.

Be sure to select the "Submit" button once the application has been completed.  You will receive confirmation that the application has been submitted.  

A notice of your status will be sent to you after the posted final filing date