Simi Valley: Maintenance Worker II (Streets) (20540727) 1. This supplemental questionnaire is designed to obtain additional information about your education, training, and experience as it relates to this position. Please answer the following questions using a separate sheet of paper. Answers to these questions may be evaluated and scored to determine the best qualified candidates to continue in the selection process. Be specific and thorough in answering the questions and do NOT indicate “See Resume” or “See Application”. Applications submitted without responses or with limited responses may not be considered for this position. Please note all information provided on your application, including these questions, are subject to verification. I have read and understand the instructions. Yes No 2. Describe your experience placing and finishing concrete sidewalks, curbs and gutters. Include the name of the employer(s) and the dates you gained this experience. 3. Describe your experience in paving, repairing and maintaining asphalt streets. Include the name of the employer(s) and the dates you gained this experience. 4. List all equipment and tools you have used for asphalt and/or concrete work that you have performed. 5. Describe your experience performing traffic control and placing street signs. Include the name of the employer(s) and the dates you gained this experience. 6. Describe your experience striping streets and parking lots; installing permanent markers and reflectors along streets; also provide what regulations you had to follow when installing striping and markings. Include the name of the employer(s) and the dates you gained this experience. 7. Do you currently possess any related certificates or specialized training related to this position such as fall protection, confined space, trend and shoring, traffic control, CPR, First Aid, forklift operator, heavy equipment operator, etc.? If so, please list your answers. 8. Do you currently possess a valid Class A driver’s license? Yes No