Winch-Truck Operator | Black Gold Energy Service

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Black Gold Energy Service, LLC is accepting job applications for WINCH TRUCK DRIVERS, HEAVY HAUL TRANSPORTATION DRIVERS & MORE!

o Must have experience in rig moving and day-to-day experience in the oil field.

o Must have a clean motor vehicle report for Class A.

o Must be able to understand and follow all company policies and procedures.

o Must pass a pre-employment drug test.

o Must be mechanically inclined.

Black Gold Energy Service offers competitive pay, full benefits and scheduled time off. All applicants must be efficient in the day-to-day work necessary to complete tasks safely and efficiently.

Pay

$20.00 – $28.00 per hour

Benefits

Dental insurance, Health insurance, Life insurance, Paid time off, Vision insurance

*FIRST NAME

*MIDDLE NAME

*LAST NAME

PHONE

EMAIL

*DATE OF BIRTH

*SOCIAL SECURITY #

*DATE OF APPLICATION

POSITION APPLIED FOR

DATE AVAILABLE FOR WORK

*Do you have legal right to work in the United States?

YES NO

CURRENT ADDRESS

Current (Most Recent) Address

STREET

CITY

STATE

ZIP CODE

# OF YEARS AT ADDRESS

PREVIOUS 3 YEARS RESIDENCY

LIST ADDRESSES FOR PREVIOUS THREE YEARS

LICENSE INFORMATION

No person who operates a commercial motor vehicle shall at any time have more than one driver's license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years.

*STATE

*LICENSE #

TYPE/CLASS

ENDORSEMENTS

EXPIRATION DATE

PREVIOUSLY HELD LICENSES

STATE

LICENSE #

TYPE/CLASS

ENDORSEMENTS

EXPIRATION DATE

DRIVING EXPERIENCE

A.

TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.)

DATE FROM

DATE TO

APPROXIMATE # OF MILES (TOTAL)

B.

TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.)

DATE FROM

DATE TO

APPROXIMATE # OF MILES (TOTAL)

C.

TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.)

DATE FROM

DATE TO

APPROXIMATE # OF MILES (TOTAL)

D.

TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.)

DATE FROM

DATE TO

APPROXIMATE # OF MILES (TOTAL)

E.

TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.)

DATE FROM

DATE TO

APPROXIMATE # OF MILES (TOTAL)

ACCIDENT RECORD FOR THE PAST 3 YEARS

CHECK BOX IF NONE

NONE

Please list accident date, nature of accident, # fatalities, # injuries, Chemical spills

Traffic Convictions and Forfeitures for the past 3 years (Other than parking violations)

Check box if NONE

NONE

Please list traffic convictions; Date - Violation - State of Violation - Penalty

*Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

YES NO

If yes, explain

*Has any license, permit, or privilege ever been suspended or revoked?

YES NO

If yes, explain

Employment History

The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require;

that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.
Start with the last or current position, including any military experience, and work backwards.
You are required to list the complete mailing address, including street number, city, state, zip; and complete all other information.

NAME

PHONE

0/10

ADDRESS

POSITION HELD

FROM

TO

REASON FOR LEAVING

SALARY

EXPLAIN ANY GAPS IN EMPLOYMENT (Include month/year & reason)

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

YES NO

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

YES NO

SECOND (MOST RECENT) EMPLOYER

NAME

PHONE

ADDRESS

POSITION HELD

FROM

TO

REASON FOR LEAVING

SALARY

EXPLAIN ANY GAPS IN EMPLOYMENT (Include month/year & reason)

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

YES NO

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

YES NO

THIRD (MOST RECENT) EMPLOYER

NAME

PHONE

ADDRESS

POSITION HELD

FROM

TO

REASON FOR LEAVING

SALARY

EXPLAIN ANY GAPS IN EMPLOYMENT (Include month/year & reason)

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

YES NO

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

YES NO

Please use this space to list any other employment as required above.

EDUCATION

HIGH SCHOOL NAME & LOCATION

COURSE OF STUDY

YEARS COMPLETED

GRADUATE

YES NO

ADDITIONAL DETAILS

COLLEGE NAME & LOCATION

COURSE OF STUDY

YEARS COMPLETED

GRADUATE

YES NO

ADDITIONAL DETAILS

OTHER EDUCATION NAME & LOCATION

COURSE OF STUDY

YEARS COMPLETED

GRADUATE

YES NO

ADDITIONAL DETAILS

OTHER QUALIFICATIONS

Please list any other qualifications that you have and which you believe should be considered.

You may upload additional documents for our review

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make investigations

(including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company. I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23. I understand that I have the right to:
• Review information provided by current/previous employers;
• Have errors in the information corrected by previous employers, and for those previous employers to resend the
corrected information to the prospective employer; and
• Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
By submitting this application, I certify that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.
Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.

Fields with (*) are compulsory.