Official SealSan Joaquin County Human Resources Division


#1122-RC0651-AC
Supplemental Questionnaire

Last Name
First Name
1.

To qualify, you must possess a valid California Class B driver's license or permit.

Do you possess a valid California Class B driver's license or permit*?

Yes No
1a.

If you answered "Yes" to Question No. 1, please provide your Class B driver's license or permit* number and expiration date (mm/dd/yyyy).

*Note: A copy of the permit must be submitted with your application.  Attach a copy to your application or send / bring a copy to the Human Resources Office. If you have a Class B permit and are offered employment, you must obtain a California Class B driver's license prior to the completion of the probationary period.

2.

PATTERN I

Do you possess three years of full-time, paid experience as a Highway Maintenance Worker or equivalent class with San Joaquin County?

Yes No
2a.

If you answered "Yes" to Question No. 2, please provide your Employee ID and dates of employment as a Highway Maintenance Worker.

3.

PATTERN II

Do you possess three years of full-time, paid experience in the operation and routine maintenance of heavy road construction and maintenance equipment?

Yes No
3a.

If you answered "Yes" To Question No. 3, please describe your experience in the operation and routine maintenance of heavy road construction and maintenance equipment.

Please include the name of your employer, job title, dates of employment, a detailed description of the duties you performed and the type of equipment you operated.