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Application


Personal Information

First Name (required)

Last Name (required)

Street Address (required)

City (required)

State (required)

Zip Code (required)

Home Phone (required)

Cell Phone

Your Email (required)

Social Security No.

Who should be contacted in case of an emergency?

Name

Phone

Street Address

City

State

Zip

 

Drivers License:

State

Number

Type


Are you over 18?

 Yes No

 


Are you a citizen of the U.S. or do you have the legal right to be employed in the United States?

 Yes No

 


Have you ever been convicted of any crime (excluding minor traffic violations) including DWI?

 Yes No

If yes,state the offense, location, date and disposition

 


What position would you like to apply for?

Desired Salary.

Current TSBPE License.

How did you hear of our company?

Are you now or do you you expect to be involved in any other business or employment?

Are there any days or hours you would unable or unwilling to work?


Plumbing Skills

What types of systems have you worked with? (Select all that apply)

 Backflow Prevention Boilers Chilled Water Chillers Circulating Systems Cold Water Systems Compressed Air Systems Distribution Systems
 Drainage Systems Heating Systems Hot Water Systems In-Floor Irrigation Systems Medical Gas Systems Radiant Heating
 Sanitation Systems Septic Systems Storm Drainage Systems Water Conditioners Water Filtration Systems Water Heaters Water Purification Systems Well Water Systems

 

 


What types of pipe and lines have you worked with? (Select all that apply)

 ABS Pipe Air Lines Black Iron Pipe Cast Iron Pipe Copper Pipe CPUC Pipe DMV Pipe FIP (Female Iron Pipe) d Flexible Hoses Galvanized Pipe IPS (Iron Pipe Size)
 MIP (Male Iron Pipe) Natural Gas Propane PVC Pipe Sanitary Lines Sewer Line Steel Pipe Supply Lines Vacuum Lines Vitrified Clay Pipe Water

 


What Applications do you have experience with? (Select all that apply)

 Clean Rooms Commercial Floating Floor Government Projects Grocery Stores Hospitals
 Industrial Multi-Family Pools Residential Restaurants Schools

 


What specific parts, pumps, valves, fittings, etc. have you worked with? (Select all that apply)

 Aerator Air Admittance Valves Air Gaps Angle Stops Ball Valves Bath Tubs Bidets Close Flanges Commercial Wall Clean Out Commodes Compressors Dish Washers Diverter Dual Check Valves Fittings Fixed Flow Restrictors Fixtures Flange Flood Stop Frost Proof Garbage Disposals
 Grease Traps Hydrant Instant Hot Water Interceptors Leaders Lift Stations Lint Traps Mixing Valves PEX insert fittings and valves Pressure Balance Valve Pressure Reducing Valves Pumps Residential Ice Maker Residential Wall Clean Out Residential 2 Way Clean Out Roof Drains Separators Septic Tank Sewage Ejectors Showers
 Shower Pan Sinks Sump Pumps Supply Stops T & P Valve Thermostatic Valve Traps Urinals Vacuum Breaker Valves Vent Washer Box Water Heater Electric Water Heater Gas Water Hammer Arrestors Water Heater Electric Water Heater Gas Water Heater Propane 2 Inch Drain 3 Inch Drain 4 Inch Drain

 

 


Military

Have you ever served in the military?

 Yes No

Service Branch?

What was you Military Occupational Speciality (MOS)?

What special training did you recieve that might help you if employed by us?


 


PERSONAL / HEALTH

Have you or are you currently having wages garnished?

 Yes No

Can you preform all specific tasks associated with the position you are applying for without any special apparatus or with minimal changes or alterations to the company?

 Yes No

Have you used any illegal grugs, including marijuana, in the last twelve (12) months?

 Yes No

Have you ever had a conviction for; driving while intoxicated, or under the influence of drugs or alcohol?

 Yes No

(If yes, when)

Are you willing to take a physical exam and a drug screen at our expense?

 Yes No

How many days leave did you take last year?

How many Fridays & Mondays did you take as leave last year?

 


Work History

Please list the last three positions held.

Company Name 1

Address, City, State, Zip

Phone Number

Name and Title of Last Supervisor

Starting and Ending Pay

Duties

Start Date

End Date

Position Held

Reason for Leaving

 

Company Name 2

Address, City, State, Zip

Phone Number

Name and Title of Last Supervisor

Starting and Ending Pay

Duties

Start Date

End Date

Position Held

Reason for Leaving

 

Company Name 3

Address, City, State, Zip

Phone Number

Name and Title of Last Supervisor

Starting and Ending Pay

Duties

Start Date

End Date

Position Held

Reason for Leaving

Have you ever worked under another name?

Are you presently employed?

 Yes No

If yes, may we contact?

 


SPECIAL WORK SKILLS

What languages do you speak and or write fluently?

Use the space below to describe why you are interested in working for us, list the skills and abilities.

 


REFERENCE

Give 3 References, not relatives.

Reference 1.
Name, Address, Phone, Occupation

Reference 2.
Name, Address, Phone, Occupation

Reference 3.
Name, Address, Phone, Occupation

 


Education & Certification

Year

School

Certification

Did you graduate?

 Yes No

 

 

Year

School

Certification

Did you graduate?

 Yes No

 

 

Year

School

Certification

Did you graduate?

 Yes No

 


In the Lines Provided Please List Your Strengths and Weaknesses.

Are you planning to pursue further studies?

List any scholastic honors, offices held.

List and describe any other school or specialized training.

 


What Certifications & Licenses do you have? (Select all that apply)

 Apprentice Plumber License Journeyman Plumber License Master Plumber License Medical Gas Backflow Prevention
 Plumbing Inspector Responsible Master Plumber License Tradesman Plumber License

 

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