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Date: 3�2fZp// 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 />Y >ee <br />❑ <br />No <br />2. <br />Parks /restroom cleaning? <br />Yes <br />❑ <br />No <br />3. <br />Painting? <br />- ❑ <br />No <br />4. <br />Work in and around sanitary sewage and perform <br />f <br />Smoke testing of sanitary sewers? <br />Yes <br />n <br />No <br />5. <br />Grounds/landscape maintenance <br />Ef " Ycs <br />❑ <br />No <br />6. <br />Garbage and Litter pick -up? <br />V / Yes <br />❑ <br />No <br />`Yes <br />7. <br />Graffiti removal? <br />❑ <br />No <br />8. <br />Concrete /asphalt? <br />h_ Yes <br />❑ <br />No <br />9. <br />Dead animal pick -up? <br />VYes <br />❑ <br />No <br />10. <br />Vegetation Removal <br />IxYes <br />❑ <br />No <br />11. <br />Work in and around poison oak? <br />Vf Yes <br />❑ <br />No <br />12. <br />Work in and around traffic hazards? <br />❑ <br />No <br />/ Yes <br />13. <br />Irrigation repair? <br />V Yes <br />❑ <br />No <br />14. <br />Heavy Labor? <br />Yes <br />❑ <br />No <br />15. <br />Work in extreme weather conditions? <br />YYes <br />❑ <br />No <br />� <br />16. <br />Provide appropriate footwear that meets safety standards? <br />Ef Yes <br />❑ <br />No <br />17. <br />Do you possess a valid CDL? (beneficial for some positions) <br />❑ Yes <br />No <br />