NOTE: You can modify this form to reflect your company’s activities, skills, equipment and tools
HEAVY EQUIPMENT OPERATOR SKILLS & EXPERIENCE
Checklist
Mark only those activities, equipment and tools with which you have experience. If hired, you will be expected to perform those activities and use the equipment and tools you indicate.
Use "F" for Fully Experienced or "S" for Some Experience.
DO NOT USE CHECK MARKS. Leave blank if you have no experience or qualifications.
TYPE OF CONSTRUCTION
____Commercial, industrial
____Road building
____Water and sewer works
____Sidewalk, curb and gutter
____Irrigation works
____Pipeline
SPECIFIC WORK PERFORMED
Grading
____Rough grading
____V-plow work
____Ditches for piping
____Ditches for foundations
____Ditches for tanks
____Padding (for backfill)
____Backsloping piping
ditches (OH&S regs)
____Sloping and banking
____Fine grading, finishing
Earthmoving
____Dig and dump
____Work to grade stakes
____Work in existing facility
____Trimming (bluetopping)
____Landscaping
____Site preparation
Pipelining and Underground
Piping Installation
____Stringing
____Lowering in
____Setting in
____Operating in swamp
terraine
Dredging
____Land-based
____Water-based
EQUIPMENT
Crawler Tractors
____Under D6 and equiv.
____D6, D7, D8 and equiv.
____D9, D10 and equivalents
Wheel Tractors
____90 drawbar hp and under
____Over 90 drawbar hp
____Loader-backhoe
Front End Loaders
____Rubber-tired
____Track type
____Bobcat
Excavators
____Backhoe, crawler
mounted, hydraulic
____Dragline, track mounted
____Telescope rotating boom
type (Gradalls)
Motor Graders
____Under 170 net h.p.
____170 net h.p. and over
Motor Scrapers
____Cat 613 and equivalents
____Cat 627 and 637, Terex
TS14 (twin motor)
____Cat 621, 631, 651, Terex TS24 (single motor)
Compactors
____Self-propelled rollers
____Pull type rollers
Paving
____Soil stabilizing machine
____Asphalt paving spreader
____Concrete spreader
____Extruder/trimmer
____Asphalt raker
____Screedman
____Road planer
____Concrete groover
Drilling and Boring
____Borers MF and equivalent
____Borers, LDH equivalent
____Tractor mounted drill
____Mobile rotary blasting drill
____Foundation drill or
caisson auger
____Diamond drills
____Posthole auger
Pipeline Equipment
____Pipe cleaning and
wrapping machines
____Bending machines
____Bead/Hot pass tractor
____Backfillers
____Sideboom under 30
tonnes
____ 30 tonnes and over
____Wheel ditchers
Please read and sign the declaration printed below:
I certify that the statements made by me are true and complete. I also understand that a false statement may disqualify me from employment or result in dismissal.
Signature: ______Date: ______