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Date: Name: (please print name) <br />Seasonal General Laborer <br />Supplemental Questionnaire <br />In order to assist us in evaluating you as a candidate, we ask that you take a few minutes to answer "yes" <br />or "no" to each of the following questions: <br />Are you willing to do .... . <br />1. <br />Building /custodial maintenance? <br />a <br />Yes <br />2. <br />Parks /restroom cleaning? <br />w <br />Yes <br />3. <br />Painting? <br />a <br />Yes <br />4. <br />Work in and around sanitary sewage and perform <br />Smoke testing of sanitary sewers? <br />Yes <br />5. <br />Grounds/landscape maintenance <br />a <br />Yes <br />6. <br />Garbage and Litter pick -up? <br />® <br />Yes <br />7. <br />Graffiti removal? <br />Ig <br />Yes <br />8. <br />Concrete /asphalt? <br />® <br />Yes <br />9. <br />Dead animal pick -up? <br />a <br />Yes <br />10. <br />Vegetation Removal <br />a <br />Yes <br />11. <br />Work in and around poison oak? <br />® <br />Yes <br />12. <br />Work in and around traffic hazards? <br />n <br />Yes <br />13. <br />Irrigation repair? <br />® <br />Yes <br />14. <br />Heavy Labor? <br />® <br />Yes <br />15. <br />Work in extreme weather conditions? <br />® <br />Yes <br />16. <br />Provide appropriate footwear that meets safety standards? <br />M <br />Yes <br />17. <br />Do you possess a valid CDL? (beneficial for some positions) <br />❑ <br />Yes <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />• No <br />a No <br />