Driver Employment Application

	"BIG OR SMALL, WE HAUL IT ALL" Mike Poppe, President - Precision Heavy Haul, Inc.
	Heavy Specialized Transport Services Rigging, Plant Re-Locations Machinery Moving & Steel Fabrication

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DRIVER'S APPLICATION FOR EMPLOYMENT

Precision Heavy Haul is an Equal Opportunity Employer and a drug-free company.
It is our policy to comply with all applicable State and Federal laws prohibiting discrimination in employment based on race, color, sex, religion, national origin or other protected classifications.

As a drug-free company, we require all employees to take a urinalysis test as a condition of their employment.

Position applied for:
Driver / Equipment Operator
Other - Please Specify:

How did you learn about us?
Classified Advertisement
Employment Agency
Friend
Relative
Website
Other -Please Specify:

Are you willing to relocate?
Yes No

Location Desired:

First Name MI Last Name

Address:
City:
State: Zip:

Day Phone

Evening Phone

E-mail Address

Date of Birth

Address for past three years: How Long?
Street City, State, Zip How Long?
Street City, State, Zip

Are you currently employed?
Yes No

May we contact your present employer?
Yes No

Have you ever worked for Precision Heavy Haul before?
Yes No

If Yes, please indicate where and when:

Are you available to work: Check all that apply
Full Time Part Time Shift Work Temporary

Are you currently on "lay-off" status and subject to recall?
Yes No

Can you travel if a job requires it?
Yes No

Proof of citizenship or immigration status will be required upon employment.
Do you have legal right to work in the United States?
Yes No

Can you provide proof of age?
Yes No

On what date would you be available for work?

Expected rate of pay - Hourly: Annual:

Have you been convicted of a felony?
(Conviction will not necessarily disqualify an applicant from employment).
Yes No

If Yes, please explain:

2. Employment History

Start with your present or most recent job, and include any job-related military service assignments (if applicable).

Current or Previous Position #1:

Employer

Address

Telephone Number(s)

Job Title / Position

Supervisor

Reason For Leaving

Dates Employed
From To
Hourly Rate/Salary
Starting Final
Work Performed

Previous Position #2:

Employer

Address

Telephone Number(s)

Job Title / Position

Supervisor

Reason For Leaving

Dates Employed
From To
Hourly Rate/Salary
Starting Final
Work Performed

Previous Position #3:

Employer

Address

Telephone Number(s)

Job Title / Position

Supervisor

Reason For Leaving

Dates Employed
From To
Hourly Rate/Salary
Starting Final
Work Performed

Previous Position #4:

Employer

Address

Telephone Number(s)

Job Title / Position

Supervisor

Reason For Leaving

Dates Employed
From To
Hourly Rate/Salary
Starting Final
Work Performed

3. Education History

High School
School Name:
Address:
Major:
Years Completed:
Diploma Earned?	Yes No

College
School Name:
Address:
Major:
Years Completed:
Diploma/ Degree:

Trade School or Other (please specify)
School Name:
Address:
Major:
Years Completed:
Diploma/ Degree:

4. Driving History

Driver License:

State	License#	Type	Expiration

Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Yes No

Has any license, permit or privilege ever been suspended or revoked?
Yes No

Explain:

Driving Accidents:

Accident record for past 3 years:

Date	Nature	Fatalities?	Injuries?

Traffic Convictions:

Traffic convictions & forfeitures for past 3 years

Location	Date	Charge	Penalty

Driving Experience:

Please check the following where you have experience and/or are familiar with:

Tractors Driven	Cab Over	Conventional
IHC/Navistar
Kenworth
Freightliner
Peterbilt
Ford
Other

Transmissions
1) 4x4 (16 speed)
2) 5 speed
3) 6 speed
4) 9 speed
5) 10 speed
6) RT910
7) Fuller 913(13 speed)
8) Fuller 12513(13 speed)
9) 5 speed main - 3 speed aux.
10) Triplex (15 speed)
11) Eaton automatic
12) Other

Trailers
1) Removable Goose Neck
2) Drop Deck
3) 5 axle combination
4) 7 axle combination
5) 9 axle combination
6) 10 + axle combination
7) Flat Bed
8) Steerable Dolly
9) Hydraulic Dovetail
10) Schnabel
11) Stretch
12) Lowbeds
13) Platform trailer

Equipment Hauled (or equivalent to)
1) CAT 966 Loader
2) CAT 980 Loader
3)CAT 631 Scraper
4)CAT 637 Scraper
5)CAT 345 Excavator
6)CAT 365 Excavator
7)CAT 769 Haul Truck
8)CAT D7 Dozer
9)CAT D8 Dozer
10)Grove RT600 Crane
11)Crushing Equipment
12)Motor Graders

List any other equipment hauled:

List maximum overall dimensions (L, W, H) and weight you have hauled:

Number of years transporting equipment:

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge, and I understand that, if I am employed, any false statements, omissions or misrepresentations may result in my dismissal. I hereby authorize Precision Heavy Haul, Inc. to investigate any and all of the facts set forth in this application.

Contact Information

Telephone: 623-936-6161

Address (click here for map): Main Office
8145 West Harrison Street: Tolleson, AZ 85353
: Fabrication Shop; 433 South 83rd Avenue
Tolleson, AZ 85353

FAX: 623-936-6222

Electronic mail: General Information: info@precisionheavyhaul.com