LABORERS’ LOCAL UNION #1140

JOB QUALIFICATIONS

Name: ______Phone: ______

Present Address: ______

In Case of Emergency Notify:

Name:______Phone: ______

License(s): ______

Certificate(s): ______

Former Employers: List below last three construction employers, starting with the last one first

Date Name/Addr of Employer Type of Work Reason for leaving

From ______

To

From ______

To

From ______

To

In filling out job classifications listed below, applicant should mark with “X” job classifications he/she is qualified to perform and has had previous experience in actual work on a construction job. If applicant is qualified for a particular job classification but does not want to perform that work, he/she should not mark that particular classification. It must be pointed out that this application is for referral to job only, and applicant’s qualification to perform classified work rests entirely with the employer.

1. Asbestos Removal ___ 19. Fall Protection ___ 37. Metric/Math Conversion ___

2. Blue Print Reader ___ 20. Fire Watch ___ 38. Mortar Men ___

3. Carpenter Tender ___ 21. First Aid/CPR ___ 39. MSHA Training ___

4. Certified Flag Person ___ 22. Foreman ___ 40. OSHA Training ___

5. Concrete Form Stripper ___ 23. Forklift ___ 41. Pavement Breakers ___

6. Concrete Chipper/Grinder ___ 24. General Laborer ___ 42. Petrogen Metal Cutting ___

7. Concrete Saw Operator ___ 25. Grade Checker ___ 43. Pile Driver Tender ___

8. Concrete Form Setter ___ 26. Grade Point Transfer ___ 44. Pipelaying ___

9. Concrete Puddlers ___ 27. Hazardous Waste Worker ___ 45. Power Tool Operator ___

10. Concrete Vibrator Man ___ 28. Highway Workzone Safety ___ 46. Refractory Worker ___

11. Confined Space ___ 29. Hoisting/Rigging ___ 47. Scaffold Work ___

12. Cutters/Burners/Torches ___ 30. Inlet Building ___ 48. Sewer Layer ___

13. Crane Operation ___ 31. Jackhammer Operator ___ 49. Shoring/Sloping ___

14. Demolition Men ___ 32. Jobsite Cleaning ___ 50. Skid Loader ___

15. Drywall Handlers ___ 33. Laser Setup ___ 51. Striking off Concrete __

16. Elevated Work Platforms ___ 34. Lead Abatement ___ 52. String Man ___

17. Estimating Brick/Block ___ 35. Lull Operator ___ 53. Tool Room Man ___

18. Excavation/ Trenching ___ 36. Mason Tender ___

54. Fear of Heights Y or N 55. Willing to Travel Y or N

Signature of Applicant: ______Date: ______

Application Received by: ______Date: ______

Remarks: ______

______