Apply for Pipe Layer/Laborer - Kukurin Contracting, Inc.

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:	Pipe Layer/Laborer
ID:	2006
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

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Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Application for Employment

PERSONAL INFORMATION

* Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment):

Yes No

* Are you at least 18 years or older? (If no, you may be required to provide authorization to work):

Yes No

* Have you ever worked for this Company before?:

Yes No

If Yes, please provide details (Where/When/Job Title):

* Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?:

Yes No

If no, please explain:

EMPLOYMENT DESIRED

* When would you be available to begin work?:

* Type of employment desired:

Full-Time
Part Time
Seasonal

* Hourly rate/salary desired:

* Are you currently employed?:

Yes No

If so may we inquire of your present employer?:

Yes No

If presently employed, why are you considering leaving?:

EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location	Did you Graduate?	Degree Received	Subjects Studied/Major
	Yes No
	Yes No
	Yes No

If you have completed any special courses, seminars and/or training that would help you to perform the position for which you are applying, please describe:

EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

EMPLOYER 1

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 2

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 3

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

REFERENCES Please provide three references (not relatives).

Name	Relationship	Phone Number	Email

AUTHORIZATION

The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

* Signature (type name):

* Date:

Pipeline Experience - Sewerline

Sewerlines

* Have you ever done sewer work?

Yes No

* Please rate your experience level:

	Very Experienced
	Moderately Experienced
	Not Experienced

List types and sizes of pipe used:

* Have you ever used Trench boxes?

Yes No

If Yes, what depths of trench did you work in?

What types of shoring have you used?

* Can you read a blueprint?

Yes No

* Can you prepare an as-built (red-line) drawing?

Yes No

* Have you done tie-in connections to live sewers?

Yes No

* Have you done lateral-lateral connections?

Yes No

* Experience with Manholes (check all that apply):

* Have you ever poured manhole inverts?

Yes No

* Have you ever dog housed manholes?

Yes No

* Can you set up a laser beam?

Yes No

* Can you use a transit or level?

Yes No

* Can you read cut sheets?

Yes No

* Have you ever done sewer/manhole rehabilitation work?

Yes No

* Have you ever air tested?

Yes No

If yes, how many pounds of pressure?

* Have you ever mandrel tested?

Yes No

* Have you ever vacuum tested?

Yes No

* Have you ever used a sewer jet or rodding machine?

Yes No

If yes, what kind?

* Can you calculate grade?

Yes No

If yes, answer this: If a line is 100 ft long and the fall is two feet, what is the percent of grade?

HDPE Pipe

* Have you ever fusion welded?

Yes No

Have you ever tapped under pressure?

Yes No

Have you ever laid HDPE Pipe?

Yes No

Are you a certified fusion welder?

Yes No

Pipeline Experience - Waterline

Waterlines

* Have you ever worked on Waterlines?

Yes No

List what types and diameters worked on:

What was your average feet per day:

Waterline Services

* Have you ever worked on Services?

Yes No

* Tapped under pressure:

	Very Experienced
	Moderately Experienced
	Very Little to No Experience

* Tapping sleeve & valves:

	Very Experienced
	Moderately Experienced
	Very Little to No Experience

* Bored:

	Very Experienced
	Moderately Experienced
	Very Little to No Experience

* Have you done hot "live" taps in 4" and larger lines?

Yes No

* Did you run the live tapping machines?

Yes No

If Yes, what sizes did you make?

* Have you run a mole hog or drill for long services?

Yes No

* Can you measure and cut pipe to do a complete tie-in on your own?

Yes No

* Experience with Flange Fitting:

	Very Experienced
	Moderately Experienced
	Very Little to No Experience:

HDPE Pipe

* Have you ever done HDPE pipe fusion welding?

Yes No

Are you a certified fusion welder?

Yes No

Fusion Welding:

	Very Experienced
	Moderately Experienced
	Very Little to No Experience

Tapped under pressure:

	Very Experienced
	Moderately Experienced
	Very Little to No Experience

Laid HDPE Pipe:

	Very Experienced
	Moderately Experienced
	Very Little to No Experience

General Field Laborer

* Have you worked construction before?

Yes No

* Type of Construction Experience (check all that apply):

	Residential
	Commercial
	Industrial
	Utility

* What are you applying for?

* Do you have a vehicle?

Yes No

* Will you drive 1-2 hours to work?

Yes No

* Can you drive a stick shift pickup truck?

Yes No

* Do you have Mechanical ability?

Yes No

Mechanical Ability (check all that apply):

* Do you have Carpentry skills?

Yes No

Carpentry Skills (check all that apply):

	Finish
	Rough
	Forming
	Erco Panels

* Do you have Drywall/Plaster skills?

Yes No

Drywall/Plaster Skills (check all that apply):

	Hang Board
	Tape/Finish
	Hard Coat

* Do you have Plumbing skills?

Yes No

Plumbing Skills (check all that apply):

	Rough Ins
	Drains
	Soldering
	Fixtures

* Do you have Electrical skills?

Yes No

Electrical Experience (check all that apply):

	Rough Ins
	Hang Fixtures
	Pull Wires

* Do you have experience in Landscaping?

Yes No

Landscaping Equipment (check all that apply):

	Hay Mulcher
	Hydro Seeder
	Hand Seeder
	Lime Fertilizer Spreader

* Do you have experience with Concrete (Structural) work?

Yes No

Concrete (Structural) Experience (check all that apply):

	Tie Rebar
	Forms
	Make Grade

* Do you have Concrete (General) experience?

Yes No

Concrete (general) Experience (check all that apply):

* Do you have Masonry skills?

Yes No

Masonry Experience (check all that apply):

	Block
	Brick
	Stone

* Do you have Paving experience?

Yes No

Paving Experience (check all that apply):

	Residential Driveways
	Commercial
	Highway Work

* Have you ever done road work?

Yes No

Road Work Experience (check all that apply):

* Can you use and read a tape measure?

Yes No

* Can you read a transit level?

Yes No

* Are you able to lift 100lbs?

Yes No

* Are you afraid of heights?

Yes No

* Are you afraid of depths?

Yes No

* Have you ever built scaffolding?

Yes No

If yes, what was the height?

* Have you ever worked in a trench?

Yes No

If yes, what was the depth?

* Have you ever worked inside shoring or shoring boxes?

Yes No

If yes, what was the depth?

* Do you have Welding/Cutting experience?

Yes No

Welding/Cutting Experience (check all that apply):

Please write a brief description of your skills and why you would be an asset to Kukurin Contracting, Inc. if hired.

Heavy Equipment Operator

* Do you have a CDL?:

	Yes
	No

* Do you have at least 2 years experience operating large excavators in a construction setting?:

	Yes
	No

* Do you have a valid drivers license?:

	Yes
	No

* Are you able to lift/carry at least 50lbs unassisted?:

	Yes
	No

* Are you willing to travel and stay overnight for out-of-town projects?:

	Yes
	No

* This position is also a labor position. Are you able to perform labor work?:

	Yes
	No

* Do you have general carpentry experience?:

	Yes
	No

* Do you have experience on large excavation projects?:

	Yes
	No

* Do you have OSHA 10?:

	Yes
	No

* Please list any Certifications you have obtained::

Submit

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	Brick
	Pre-Cast
	Poured Base
	Mono Base
	None of the Above

	Water/Sewer Line Work
	Plant Work
	Paving Work
	Bridge Work
	All of the Above

	Cars
	Trucks
	Tractors
	Equipment/Heavy Equipment
	None of the Above

	Residential Sidewalks
	Residential Footers
	Residential Floors
	Commercial Curb Sidewalks
	Commercial Footers
	Flat Floor Slabs

	Curb or Sidewalk
	Block or Brick Work
	Formed Concrete Work
	Asphalt by Hand or Paver
	PennDOT Work

	American Indian or Alaska Native (Not Hispanic or Latino) A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
	Black or African American (Not Hispanic or Latino) A person having origins in any of the Black racial groups of Africa
	Hispanic or Latino A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
	Asian (Not Hispanic or Latino) A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
	White (Not Hispanic or Latino) A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
	Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
	Two or More Races (Not Hispanic or Latino) All persons who identify with more than one of the above races
	I Choose Not to Respond

	Individual with a Disability An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
	Vietnam Era Veteran A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
	Disabled Veteran 1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
	War/Campaign/Expedition Veteran A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
	Armed Forces Service Medal Veteran A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
	Recently Separated Veteran Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
	I Choose Not to Respond