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DRIVER'S APPLICATION FOR EMPLOYMENT
(Please answer all questions)

 PRECISION HEAVY HAUL, INC
P.O. BOX 797
TOLLESON, AZ 85353
This application is intended to comply with FMCSR 391.12 for commercial truck drivers. All applicants must meet minimum requirements for truck drivers per these regulations. In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disability.

AMERICANS WITH DISABILITIES ACT NOTICE: All applicants are evaluated on their ability to perform job-related functions. Please do not include any information on this application which may indicate you have a disability. If you are selected for an employment interview, please be prepared to describe and/or demonstrate how, with or without reasonable accommodations, you will perform the job related functions. Also, please inform the Employment Office Staff if you need any reasonable accommodation to take any pre-employment tests.
 
Date of application: Position applied for: CDL TRUCK DRIVER
 
First Name MI  Last Name
 

Address
Street Number :
City :
State :
Zip :
 
Day Phone Cell
 

Address For Past 3Years
Street Number City,State ,Zip
How Long?
Street Number City,State ,Zip
How Long?
Street Number City,State ,Zip
How Long?
 
Do you have the legal right to work in the United States?
 

Date of Birth

DateMonthYear
 
Can you provide proof of age?
Yes  No
Rate of pay expected?
Have you worked for this company before?
Yes  No
Where/When?
Who referred you?
How did you hear about us?
Is there any reason you might be unable to perform the functions of the job for which you have applied?
 
PRE-EMPLOYMENT QUESTIONNAIRE
How many years of commercial tractor/trailer experience?
Have you ever been convicted of a felony?
State CDL issued in
Endoresements-list all
Are you familiar with the local height routes?
Curfew zones/times
Approximate number of miles commercially driven?
List all states operated in
Which safe driving awards do you hold and from whom?
 

Circle the make(s) of tractors driven:

Kenworth Cab Over Conventional
Peterbuilt Cab Over Conventional
Freightliner Cab Over Conventional
IHC/Navistar Cab Over Conventional
Ford Cab Over Conventional
OTHER LIST
 

Check the type of transmission(s) and rear axles used:

10 speed
13 speed
15 speed
18 speed
2 speed aux
4 speed aux
Automatic
OTHER
speed rear ends
Planetary
OTHER

For the types of trailer(s) listed below write in all makes and models & capacity that you have pulled:
Flatbed
Stretch Flat (bed)
RGN Mechanical
Hydraulic sliding axle
Stretch Lowboy
Steerable dolly
Holland type dollys
Basket dolly
Bolster & dolly
Suspension beams
Schnabel's
Perimeter Frame
Platform trailers (Goldhofer type)
Dual lane equipment
List any other trailers

Check all the numbers of axle combination (s) pulled:
5 6 7 8 9 10 11 12 13 14
15 16 17 18 19 20 21 22 23 24+

List all makes & model of the equipment you have transported below:
Aircraft
Bridges
Beams
Cranes
Crushing equipment
Dozers
Drillrigs
Excavators
Hot plants
Loaders
Marine
Mining equipment
Misc. equipment
Motor graders
Paving equipment
Power Generation Equipment (Transformers, Generators, Turbines, Est.)
Pipe
Prefab concrete structures
Rail Road equipment
Rock trucks
Scrapers
Steel fabricated equipment
Trenchers

RIGGING EXPERIENCE:

List type of experience (what you did) and the type of rigging equipment used:

CRANE OPERATING EXPERIENCE

(what and how long)

FORKLIFT CERTIFIED? DATE OF EXPIRATION:

TYPE OF FORKLIFTS USED

LIST ANY SPECIALIZED TRUCKING, TRANSPORATION, OR OTHER EXPERIENCE THAT MAY HELP IN WORKING FOR THIS COMPANY

LIST ANY COURSES OR TRAINING ADDITIONAL TO WHAT IS SHOWN ELSEWHERE IN THIS APPICATION

LIST OTHER SPECIAL EQUIPMENT OR TECHNICAL MATERIALS OR SKILLS

EMPLOYMENT HISTORY
All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. Applicants to drive a commercial motor vehicle intrastate or interstate commerce shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle. NOTE: List employers in reverse order starting with the most recent. PLEASE fill out completely and accurately with ALL information and no missing dates in employment!
Table-1
Name of the Employer

Address
Street Number :
City :
State :
Zip :
Name of Last supervisor Employement dates Pay or Salary
From:
To:
Start:
Final:
Your last Job title 
Reason for leaving (be specific) 
List the job you held, duties performed, skills used or learned,advancements or promotions while you worked at this company.
Table-2
Name of the Employer

Address
Street Number :
City :
State :
Zip :
Name of Last supervisor Employement dates Pay or Salary
From:
To:
Start:
Final:
Your last Job title 
Reason for leaving (be specific) 
List the job you held, duties performed, skills used or learned,advancements or promotions while you worked at this company.
Table-3
Name of the Employer

Address
Street Number :
City :
State :
Zip :
Name of Last supervisor Employement dates Pay or Salary
From:
To:
Start:
Final:
Your last Job title 
Reason for leaving (be specific) 
List the job you held ,duties performed, skills used or learned,advancements or promotions while you worked at this company.
Check highest grade completed:
1 2 3 4 5 6 7 8 | 		High School
9 10 11 12 | 		College
1 2 3 4
Last School attended:
  (Name) (city)
TYPE OF SCHOOL NAME OF SCHOOL LOCATION
(Complete mailing address)		 NUMBER OF YEARS COMPLETED MAJORE & DEGREE
High School    
        
College    
 
Bus.Trade school    
Professional School    
Have you ever had your license revoked or suspended?
Yes  No
Have you had any accidents in the last 3 years?
Yes  No
Have you had any tickets in the last 3 years?
Yes  No
Have you been convicted of DWI, DUI or BAC in the last 5 years?
Yes  No
Have you ever been convicted of a crime?
Yes  No
If you answered 'Yes' to any of the previous 5 questions please give details below.
TO BE READ AND SIGNED BY APPLICANT
I agree that any false statement, misrepresentation, or omission in this application is sufficient cause for rejection for employment or for dismissal if hired. I authorize my former employer(s) and others to give PRECISION HEAVY HAUL, INC, all information regarding my services, character, and conduct, and furthermore do release them and their company from any liability for any damage resulting there from. I also authorize a credit check, drivers license check, application for bonding, and agree to submit to medical examinations as deemed necessary by PRECISION (generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended. All drivers must fit minimum physical requirements as required by the FMCSR.)

I understand that I may be randomly tested for substance use at any time as a condition of employment.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge
Application Signature Date
Printed Name
IMPORTANT NOTICE
BACKGROUND REPORT AKNOWLEDGEMENT
PRE-EMPLOYMENT SCREENING
In connection with my application for employment with Precision Heavy Haul Inc ("Prospective Employer") renine may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA). If the prospective employer uses information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective employer will notify you that the action has been taken and that the action was obtained in part or in whole on this report. The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing. If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

I authorize Precision Heavy Haul Inc. (‘Prospective Employer’) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Precision Heavy Haul Inc to make a determination regarding my suitability as an employee.

I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety date that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I am challenging crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded to the DataQs system to the appropriate State for adjudication.

I have read the above Notice Regarding Background Reports provided to me by Prospective Employer- Precision Heavy Haul Inc, and I understand that by signing below I am consent to Precision Heavy Haul Inc obtaining a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.
Date Signature
Printed Name
DISCLOSURE AND RELEASE
In connection with my application for employment (including contract for services) with you, I understand that consumer reports which may contain public record information may be requested from DAC Services in Tulsa, OK. These reports may include the following types of information; names and dates of previous employers, reason for termination of employment, work experience, accidents, etc. I further understand that such reports may contain public record information concerning my driving record, workers compensation claims, credit, bankruptcy proceedings, criminal records, etc., from federal, state, and other agencies which maintain such records; as well as information from DAC concerning previous driving record requests made by others from such state agencies, and state provided driving records.

I also understand that a claims history report may be requested from Great West Casualty Company. This report may include the following information with regard to my driving history, accident dates, state of accident location, and a brief description of the accident.

I AUTHORIZE, WITHOUT RESERVATION, ANY PART OR AGENCY CONTACTED BY DAC OR GREAT WEST CASUALTY COMPANY TO FURNISH THE ABOVE MENTIONED INFORMATION.

I have the right to make a request to DAC, upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of the information, and the recipients of any reports on me which DAC has previously furnished within the two year period preceding my request. I hereby consent to your obtaining the above information from DAC, and I agree that such information which DAC has or obtains, and my employment history with you if I am hired, will be supplied by DAC to other companies which subscribe to DAC services.

I also have the right to make a request to Great West Casualty Company, upon proper identification, to request the nature and substance of all information in its files on me at the time of my request.

I hereby authorize procurement of consumer report (s). If hired (or contracted), this authorization shall remain on file and shall serve as an ongoing authorization for you to procure consumer reports at anytime during my employment (or contract) period.
PRINT NAME SSN
APPLICANT'S SIGNATURE DATE LICENSE NUMBER STATE
DATE OF BIRTH YEARS COMMERCIAL EXPERIENCE
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.
 
 
Precision Heavy Haul Inc. of Tolleson Arizona est. in 1984 is not affiliated with Precision Heavy Haul of Stilwell Kansas est. in 2003. We take our safety rating very seriously. When checking CSA ratings be sure you are reviewing Precision Heavy Haul Inc. DOT #490862
CONTACT US
Telephone623-936-6161
FAX 623-936-6222
 
Main Office
8145 West Harrison Street
Tolleson, AZ 85353
 
Fabrication Shop
433 South 83rd Avenue
Tolleson, AZ 85353
 
General Information
info@precisionheavyhaul.com
 
WHAT OUR CUSTOMERS ARE SAYING

"PHH has proven to be the most reliable, conscientious, and safe transportation provider we could have asked for. Every employee of this company is dedicated to getting your job completed correctly..."

James H. Slagle, Large Binocular Telescope

"Precision Heavy Haul has consistently out-performed the other haulers..."

Bob Tarlowski, Arizona Public Service

"Over the past fifteen or so years, Salt River Project (SRP) has done business with Precision Heavy Haul or (PHH). "

Scott Moore, Salt River Project
Copyright @ 2011 Precision Heavy Haul, Inc.
All rights reserved.