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Santa Cruz County Personnel Department

Supplemental Questionnaire

Last Name First Name



The supplemental questions are designed specifically for this recruitment. Applications received without the required supplemental information will be screened out of the selection process. Employment experiences referred to in your responses must also be included in the Employment History section of the application.

NOTE: Please answer the supplemental question(s) as completely and thoroughly as possible, as your answer(s) may be used to assess your qualifications for movement to the next step in the recruitment process.


Do you possess a valid Certificate of Registration as an Environmental Health Specialist issued by the California Department of Public Health? If yes, submit a copy of your certificate and/or a current registration card by fax to (831) 454-2240 or email to:

Yes No

Describe your training and experience in conducting inspections to determine compliance with Federal, State and local health codes and regulations.


Describe your training and experience which demonstrate your knowledge, skills and abilities in each of the following program areas:

  1. Land use, such as onsite wastewater disposal systems, enhanced or alternative treatment technologies, site suitability evaluations of soils and percolation rates; private residential and agricultural water well siting, well construction and destruction permits, water recycling, water pollution controls, and complaint investigations; environmental review plan checks for building permits and discretionary projects.

  2. Consumer protection, such as food safety, facility inspections and plan checks, foodborne illness investigations, Hazard Analysis Critical Control Point (HACCP) plans, public bathing places, housing and institutions, body art, medical waste, vector control and abatement, general sanitation, public presentations, and enforcement activities.

  3. Certified Unified Program Agency (CUPA) activities including hazardous materials and hazardous waste inspections, investigations, emergency response and enforcement activities.