Supplemental Questionnaire

	Placer County Human Resources Department

	#2021-11721-01
	Supplemental Questionnaire


Last Name	First Name

ENVIRONMENTAL HEALTH TECHNICIAN I

SUPPLEMENTAL QUESTIONNAIRE

2021-11721-01

This supplemental questionnaire is the examination for this recruitment. The supplemental questionnaire is the only item used to determine your examination score.

Applicants must complete Parts I, II, and III of the supplemental questionnaire to be considered for the current recruitment.

Please note: Resumes, letters, and other attached materials will not be evaluated or taken into consideration as responses to this supplemental questionnaire.

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 understood the above information.

PART I: Minimum Qualifications Screening (Not Scored)

Questions in this section will be used to gather more information about your background and experience; they will not be included as part of the examination score.

Do you possess the equivalent to the completion of the twelfth grade supplemented by at least twelve semester units of college level courses in chemistry, biology, toxicology or a related field?

Yes No

If you checked yes, please list below the college level courses and the number of units for each course. If no, you are encouraged to review the job posting and minimum qualifications for this position.

PART II: Specialized Skills (Not Scored)

Please note that indicating "No" to any question in this section does not exclude you from participation in this recruitment.

Are you English/Spanish bilingual? (Placer County may administer a Spanish Language Skills Examination as part of the selection process.)

Yes No

Are you English/Russian bilingual? (Placer County may administer a Russian Language Skills Examination as part of the selection process.)

Yes No

PART III: Experience and Training (Scored)

Based on your responses to the questions in Part III of this supplemental questionnaire, your job-related experience and training will be evaluated using a pre-determined formula. Scores from this evaluation will determine applicant ranking and placement on the eligible list. Please note that narrative responses provided in this section will not be scored but may be used by the hiring authority to determine which applicants they will invite to their hiring interviews.

For the following questions, select the response that best corresponds with your relevant training and/or experience.

Describe your experience conducting field inspections to assure regulatory compliance.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated experience above, please describe with detail below:

Describe your experience processing environmental health applications and reviewing for compliance with standards and regulations.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated experience above, please describe with detail below:

Describe your experience performing plan review and conducting basic research within a database system.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated experience above, please describe with detail below:

Describe your experience logging and maintaining various data and records and preparing reports.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated experience above, please describe with detail below:

Describe your experience preparing and distributing a variety of self-help related materials pertaining to environmental issues.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated experience above, please describe with detail below:

Describe your knowledge of the advanced operation of varied office equipment including computers and associated word processing, spreadsheets, and specialized applications.

I have no knowledge or a very limited amount of this knowledge.

I possess this knowledge but have not applied it in a job setting.

I have applied this knowledge under close supervision.

I have applied this knowledge independently under normal supervision.

I have used this knowledge to train or provide consultation to others.

If you indicated knowledge above, please describe with detail below:

Describe your ability to use a variety of modern office equipment, including but not limited to, computer, calculator, typewriter, telephone, facsimile machine, microfilm reader/printer, and photocopy machine.

I possess no ability or a very limited amount of this ability.

I possess this ability but have not applied it in a job setting.

I have applied this ability under close supervision.

I have applied this ability independently under normal supervision.

I have used this ability to train or provide consultation to others.

If you indicated ability above, please describe with detail below:

Describe your experience building and maintaining positive working relationships with both internal and external customers.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated experience above, please describe with detail below:

Describe your experience using the principles and practices of customer service and working fairly and courteously with the public.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated knowledge above, please describe with detail below:

10.

Describe your ability to obtain information through interviews and dialogue.

I possess no ability or a very limited amount of this ability.

I possess this ability but have not applied it in a job setting.

I have applied this ability under close supervision.

I have applied this ability independently under normal supervision.

I have used this ability to train or provide consultation to others.

If you indicated ability above, please describe with detail below:

11.

Describe your experience working with various cultural and ethnic groups in a tactful and effective manner.

I have no experience or a very limited amount of experience performing this task.

I have been trained on how to complete this task but have not done so in a job setting.

I have experience performing this task under close supervision.

I have experience performing this task under normal supervision.

I have experience performing this task and have trained and/or provided consultation to others.

If you indicated experience above, please describe with detail below:

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

Please click "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.