Careers

This field is for validation purposes and should be left unchanged.

Applying For(Required)

(check all positions qualified)

Concrete Mixer Driver [Class A or B]

Cement Tanker Driver [Class A w/Tank Endorsement – minimum of 1 year OTR driving experience]

Concrete Pump Operator [Class A or B – minimum of 5 years Concrete Mixer experience or previous crane/boom experience preferred]

Applicant Legal Name(Required)

First Middle Last

Email(Required)

SSN #(Required)

Phone #(Required)

Cell Phone #

Address(Required)

Street Address Address Line 2 City State ZIP Code

How long at this address?(Required)

(Years/Months)

If less than three (3) years, list all previous addresses in the last three (3) years below.

Previous Addresses

Street

City/State

Zip

How Long? (Years/Months)

Are you now employed?(Required)

Yes

If yes, is it okay to contact employer as a reference?

Yes

How did you learn about this employment opportunity?

Rate of pay expected?

Driver's License History

List all licenses or permits held in the last three (3) years.(Required)

State

License Number

Class

Endorsement(s)

Expiration Date

Date CDL License was first obtained:(Required)

List States operated in for last five years:(Required)

Have you EVER been denied a license, permit, or privilege to operate a motor vehicle?(Required)

Yes

Has any license, permit, or privilege EVER been suspended or revoked?(Required)

Yes

If you answered “Yes” to either question above, give facts and circumstances:

Driver Experience

Class of Equipment

Type of Equipment (Van, Flatbed, Dump, Tank, etc.)

From Month/Year

To Month/Year

Miles Driven

Have you had any accidents in the last three (3) years?(Required)

Yes

Accident Record(Required)

List ALL accidents in the last three (3) years.

Date

City & State (Location)

Nature of Accident (Head-on, Rear-end, Upset, etc.)

Fatalities?

Injuries?

Personal or Commercial Vehicle?

Have you had any Traffic Convictions or Forfeitures (other than parking tickets) in the last three (3) years?(Required)

Yes

Traffic Convictions and Forfeitures(Required)

List ALL in the past three (3) years (other than parking tickets).

Date

City & State (Location)

Charge

Penalty

Personal or Commercial Vehicle?

Employment History

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address and contact information beginning with your current employer or most recent employer.

Applicants to drive a commercial motor vehicle in intrastate or interstate commerce shall also provide an additional 7 years’ information on those employers for whom the applicant operated such a vehicle.

Employment History(Required)

Employer Name:

Position Title:

From:

To:

Phone

Address:

City/State/Zip:

Reason for Leaving:

Were you subject to Federal Motor Carrier Safety Regulations (FMCSRs) while employed?

Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug & alcohol testing requirements of 49 CFR part 40?

Account for time between jobs (month/year) and reason:

Declaration of Employment Status (Gaps in History) *MUST COMPLETE IF APPLICANT DROVE A CMV*

If you were driving a CMV, you must provide complete employment history for the past 10 years. Any gaps in employment longer than 1 month are explained as follows:

Activity During Break:

From:

To:

In addition, I was not employed by any company or individual:

Show additional trucking, transportation, or other experience that may help you work for this company:

List special courses or training that will help you as a driver:

List special equipment or technical materials you can work with:

History for Controlled Substance and Alcohol under CFR 49 part 40 subpart B or part 382

Have you ever tested positive or refused to test on any pre-employment drug or alcohol test administered by an employer to which you applied for but did not obtain safety sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years?(Required)

Yes

Have you tested positive or refused any drug or alcohol test administered by an employer when you were in safety sensitive work and such activity was regulated by CFR 49 part 40 subpart B or part 382?(Required)

Yes

If yes to either question above, please explain and provide proof of completed return to duty process prescribed by a substance abuse professional.

To be Read and Signed by Applicant

I authorize you to make such investigations and inquires of personal, employment, financial or medical history and other related matters as necessary in arriving at an employment decision. (Generally inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) 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 interviews may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

I understand information I provide regarding current and/or previous employers may be used, and those employers will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23 (d) and (e). I understand I have the right to:

Review information provided by the previous employers;
Have errors in the information corrected by previous employers and for employers to re-send 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.

Driver employees who have previous Department of Transportation regulated employment history in the preceding three years, and wish to review previous employer provided investigative information, must submit a written request to the prospective employer, which may be done at any time, including when applying or as late as thirty (30) days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), then the five (5) business day deadlines will begin when the prospective employer receives the requested safety performance history information. If the driver has not arraigned to pick up or receive the requested records within thirty (30) days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived their request to review the records.

This certifies this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Signature(Required)

Date(Required)

Job Applicant Policy Acknowledgement and Release of Testing Information Form

NOTICE TO ALL APPLICANTS: Please review Notice Regarding Job Applicant and Employee Drug and Alcohol Testing before signing this form. In order to be considered or employment, this form must be signed and returned with your application.

As an applicant of Heritage Concrete your signature verifies that you agree with the following:

I have read and understand the Notice Regarding Job Applicant and Employee Drug and Alcohol Testing. I specifically authorize the results of the pre-employment /pre-placement urine drug test and breath alcohol test released to the representatives of Chemquest, Inc. (a third-party administrator) and then released to HMA Concrete LLC dba Heritage Concrete. This information will only be collected and released to both parties after an offer for employment has been extended. All offers of employment will be conditional upon the results of stated testing.

Signature:(Required)

SSN #:(Required)

Date:(Required)

Additional Information

If there is additional information you'd like to share with us, please do so here:

Thank you for your interest in Heritage Concrete

Safety Is Our Foundation

Driver Application