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#CBT-7120-901865
Supplemental Questionnaire

Last Name
First Name

 

SUPPLEMENTAL APPLICATION

INSTRUCTIONS: This supplemental questionnaire will be used to assess possession of the minimum qualifications for the 7120 Buildings and Grounds Maintenance Superintendent for which you are applying. Supporting documentation (such as licenses, letters, resumes, etc.) will not substitute for this supplemental application. This supplemental application MUST be submitted with the official application and all documentation verifying your qualifications at the time of filing. 

Please ensure that the information on this supplemental application and any documentation provided is consistent with the license, education, training, certification and employment record sections of your application. Inconsistent or incomplete information will result in rejection of the application.


1

I possess eight (8) or more years of experience operating, maintaining and repairing a wide variety of mechanical, electrical, pumping, heating, air conditioning, ventilation, refrigeration AND related plant machinery and systems found in large industrial, production, commercial or institutional buildings:

Yes No
2

I possess four (4) or more years of supervisory experience directing the operation and maintenance activities of subordinate personnel:

Yes No
3

If you answered "Yes" to question #2 above, describe your supervisory experience (not lead work), the number of workers you supervise(d), the type of supervision you did and the crews or individuals you directed. Please provide as much detail as you can in your response.

If you answered "No" enter "N/A".

4

List the following for each qualifying experience described in questions # 1 to 3 above:

  • Your job title(s)
  • Name(s) of employer/company/organization
  • Dates of employment
  • Your supervisor or representative who can verify the experience(s) above
  • Their working title, email and phone number

If you have indicated that you do not possess experience in these areas enter "N/A".

5

I possess a Universal Chlorofluorocarbon (CFC) certificate issued by the Federal Environmental Protection Agency for working with heating and ventilating equipment (HVAC) or other refrigeration equipment using CFC's and HCFC's:

Yes No
6

I possess a valid Driver License (California DMV Class “C” or above):

Yes No
 

By checking this box, I hereby certify that I am the author of this questionnaire and that all information is true and correct based on my background and experience. I understand that any false or incorrect statement may result in my disqualification from this exam and/or dismissal from employment with the City and County of San Francisco. I also understand and agree to provide verification, when requested.