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Supplemental Questionnaire

Last Name
First Name


6231 Senior Street Inspector
Supplemental Questionnaire

INSTRUCTIONS: The Supplemental Questionnaire will be used to assess your possession of the minimum qualifications for the 6231 Senior Street Inspector position to which you are applying. Supporting documentation (such as licenses, letters, resumes, etc.) will not substitute for this supplemental application. This supplemental application must be submitted with the official application at the time of filing.

Note: Please ensure that any information you provide below is consistent with your official application. Inconsistent or incomplete information may result in rejection of the application. The hiring department may review this information as part of their selection process.



I possess a valid driver license:

Yes No

I possess three (3) years of experience or more (check all that apply):

As a Street Inspector
Monitoring quality assurance and code compliance related to excavation, roadways and sidewalk construction
Reviewing permits, issuing permits or checking plans related to the construction of maintenance of the public right of way
None of the above

Describe your experience checked above. In your response, also list the following for EACH qualifying experience:
•Your job title(s)
•Name(s) of employer/company/organization
•Dates of employment
•Your supervisor or employer representative who can verify the experience(s) above
•Their working title, email and phone number

You may use the same person, if appropriate.

If you have indicated that you do not possess experience in these areas enter "N/A".


By checking this box, I hereby certify that I am the sole author of this supplemental application. I further acknowledge that all information provided is consistent with my employment application and is true and correct based on my education, training, skills and/or experience.  I understand that any false or incorrect statement may result in my disqualification from this and future examinations and/or dismissal from employment with the General Services Agency and City and County of San Francisco. I also understand and agree to provide verification, when requested.