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#19-001028-0005
Supplemental Questionnaire

Last Name
First Name

 

Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.


1.

Do you have training or experience sampling soil or groundwater? If yes, please explain your experience.

2.

Do you have knowledge or experience related to above ground and/or underground storage tank systems? If yes, please explain your knowledge or experience.

3.

Do you have training or experience related to oil spill containment?  If yes, please explain.  If you do not possess this experience please indicate N/A.

4.

Have you successfully completed the OSHA 40 hour Hazardous Waste Site Worker training? If yes, please upload documentation confirming completion of training.

Yes No
5.

Do you hold a valid Maryland underground storage tank system inspector, technician, or remover certification? If yes, please upload verification of certification.

Yes No
6.

Do you hold a valid precision tester certification? If yes, please upload verification of certification.

Yes No
7.

Do you have training or experience with petroleum contamination assessments and remediation? If yes, please explain your training and experience.

8.

Please explain your knowledge of Maryland regulations regarding oil pollution and tank management.

9.

Are you willing to work in the following counties; Garrett, Allegany, Washington, and Frederick County?

Yes No

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