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Date: — b — I� Name: �UfrM (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 />d Yes <br />❑ <br />No <br />2. <br />Parks /restroom cleaning? <br />of Yes <br />❑ <br />No <br />3. <br />Painting? <br />Yes <br />❑ <br />No <br />4. <br />Work in and around sanitary sewage and perform <br />Smoke testing of sanitary sewers? <br />er Yes <br />❑ <br />No <br />5. <br />Grounds/landscape maintenance <br />Yes <br />❑ <br />No <br />6. <br />Garbage and -Litter pick -up? <br />des <br />❑ <br />No <br />7. <br />Graffiti removal? <br />e Yes <br />❑ <br />No <br />8. <br />Concrete /asphalt? <br />® es <br />o <br />No <br />9. <br />Dead animal pick -up? <br />aK Yes <br />❑ <br />No <br />10. <br />Vegetation Removal <br />�s <br />❑ <br />No <br />11. <br />Work in and around poison oak? <br />V TeS <br />❑ <br />No <br />12. <br />Work in and around traffic hazards? <br />Yes <br />❑ <br />No . <br />X <br />13. <br />Irrigation repair? <br />❑ Yes <br />V <br />No <br />14. <br />Heavy Labor? <br />Yes <br />❑ <br />No <br />15. <br />Work in extreme weather conditions? <br />V <br />❑ <br />No <br />16. <br />Provide appropriate footwear that meets safety standards? <br />w-'Y�e_ s <br />❑ <br />No <br />17. <br />Do you possess a valid CDL? (beneficial for some positions) <br />le <br />❑ <br />No <br />