The document provides instructions for submitting an online application for employment with ECM Energy Services Inc. It states that after filling out the application, the applicant should click the "Submit Application" button, which will open their default email program with the application attached. They should then send the email to jobs@ecmenergy.com. The document notes that the company will contact qualified applicants whose qualifications meet their needs.

1. On-Line Application Submission
Thanks for your interest in applying for Career Opportunities with ECM Energy Services Inc. (ECM). When
you have completely filled out the online application, please click the "Submit Application" box on the last
page of the application, select your default email application and your email browser will open with the
application attached. Select send and your application will be sent to jobs@ecmenergy.com. We will be in
touch shortly should you meet the specific qualifications we are seeking and thanks again for your interest.

2. Today’s Date
APPLICATION FOR EMPLOYMENT
An Equal Opportunity Employer
ECM Energy Services Inc. (ECM) provides equal employment opportunity to all applicants, without regard to race, color,
sex, religion, age, disability, national origin, sexual orientation, marital status, military status, Vietnam-era veteran status
or any other basis prohibited by Federal or state laws. ECM complies with all applicable Federal, state and local laws
governing non-discrimination in employment in every location where ECM has facilities. ECM does not tolerate
discrimination in the workplace on any of the prohibited bases listed above.
Last Name _________________________________First _____________________________Middle _________________
Current Address ___________________________City _________________State ________________Zip _____________
Home Phone __________________________ Cell Phone ____________________________
Emergency Contact _____________________________ Relationship __________________ Phone __________________
How long have you lived at your current address? _______________________
List previous address if less than 3 years at your current address:
Address ______________________________ City _____________________ State _______________ Zip _____________
What type of position are you applying for? Water Truck Driver _______ Equipment Rentals______ Escort Driver ______
Have you ever worked for ECM before? Yes ____ No ____, If yes, where and when? ______________________________
Are you related to any current ECM employee(s)? Yes ____ No ____, If yes, who? ________________________________
Are you at least 21 years of age? Yes ____ No ____
Are you willing to submit to a pre-employment drug screen? Yes ____ No ____
How did you hear about this opportunity? ________________________________________________________________
If you were referred, who referred you? __________________________________________________________________
What are your minimum salary expectations? _____________________
What work shifts are you able and willing to work? _________________________________________________________

3. Are you willing to work in all types of weather conditions? Yes ____ No ____
Do you have a reliable means of transportation to and from work which will allow you to consistently arrive to work on
time? Yes ____ No ____
Education
Do you have a HS Diploma or GED? Yes ____ No ____
Please list all degrees (GED, HS Diploma, College/University, etc.) or certifications attained.
Degree Type City and State Start Date End Date Expiration Date (If applicable)
Criminal History
Disclosure of a criminal record or pending charges will not necessarily disqualify you from employment consideration.
Each offense will be evaluated on its own with respect to time, circumstances, seriousness and relation to the position
you are applying. Omission of information, failure to respond to questions regarding criminal record or pending charges
will automatically disqualify you from employment consideration.
Have you ever been convicted, plead guilty or no contest to a crime other than a minor traffic infraction? Note: Crimes
include misdemeanors, felonies and any other category of crime with the exception of traffic infractions. Driving under
the influence, with a license or with a suspended license is NOT considered a minor traffic offense. Information regarding
records sealed by a court of law need not be disclosed. Yes ____No ____, if yes, please explain below:
Have you ever received a deferred adjudication or been placed under any form of court supervision or probation for a
crime other than a minor traffic offense? Note: Crimes include misdemeanors, felonies and any other category of crime
with the exception of traffic infractions. Driving under the influence, with a license or with a suspended license are NOT
considered minor traffic offenses. Information regarding records sealed by a court of law need not be disclosed. Yes ____
No ____, if yes, please explain below:

4. Employment History
Please provide employment history for the last 7 years. Please provide the start and end dates for all employment
including the month and year. All employment history must be filled out completely. Failure to provide complete
employment history could result in disqualification of employment. Please explain gaps in employment of 6 months or
more.
The U.S. Department of Transportation requires that driver applicants show all employment for the past three years.
Effective July, 1987 driver’s applicants must also show commercial driver employment for the seven years
immediately preceding this three-year period. 391.21(b) (10), (11).
Federal Motor Carrier Safety Regulations Code 391.23(i).
(1) The prospective employer must expressly notify drivers with the Department of Transportation regulated
employment during the preceding three years via the application form or other written document, prior to any hiring
decision, that he or she had the following rights regarding the investigative information that will be provided to the
prospective employer:
i. The right to review information provided by the previous employers;
ii. The right to have errors in information corrected by the previous employer and for that previous employer to
resend the corrected information to the prospective employer.
iii. The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer
and the driver cannot agree on the accuracy of the information.
Are you currently employed? Yes ____ No ____ May we contact your current employer? Yes ____ No ____
Have you ever been terminated, resigned to avoid termination or been asked to resign from a job? If so, please explain
the circumstances.
Start with the current or most recent position, including military service experience.
Employer Name _____________________________ Supervisor’s Name ________________________________________
Address _______________________________ City ___________________ State ________________ Zip _____________
Telephone Number __________________________________ Fax Number ______________________________________
Position Held _________________________________ from __________ to ___________ Pay Rate __________________
Reason for Leaving ___________________________________________________________________________________
Employer Name _____________________________ Supervisor’s Name ________________________________________
Address _______________________________ City ___________________ State ________________ Zip _____________
Telephone Number __________________________________ Fax Number ______________________________________
Position Held _________________________________ from __________ to ___________ Pay Rate __________________
Reason for Leaving ___________________________________________________________________________________

5. Employer Name _____________________________ Supervisor’s Name ________________________________________
Address _______________________________ City ___________________ State ________________ Zip _____________
Telephone Number __________________________________ Fax Number ______________________________________
Position Held _________________________________ from __________ to ___________ Pay Rate __________________
Reason for Leaving ___________________________________________________________________________________
Employer Name _____________________________ Supervisor’s Name ________________________________________
Address _______________________________ City ___________________ State ________________ Zip _____________
Telephone Number __________________________________ Fax Number ______________________________________
Position Held _________________________________ from __________ to ___________ Pay Rate __________________
Reason for Leaving ___________________________________________________________________________________
Employer Name _____________________________ Supervisor’s Name ________________________________________
Address _______________________________ City ___________________ State ________________ Zip _____________
Telephone Number __________________________________ Fax Number ______________________________________
Position Held _________________________________ from __________ to ___________ Pay Rate __________________
Reason for Leaving ___________________________________________________________________________________
Employer Name _____________________________ Supervisor’s Name ________________________________________
Address _______________________________ City ___________________ State ________________ Zip _____________
Telephone Number __________________________________ Fax Number ______________________________________
Position Held _________________________________ from __________ to ___________ Pay Rate __________________
Reason for Leaving ___________________________________________________________________________________
Employer Name _____________________________ Supervisor’s Name ________________________________________
Address _______________________________ City ___________________ State ________________ Zip _____________
Telephone Number __________________________________ Fax Number ______________________________________
Position Held _________________________________ from __________ to ___________ Pay Rate __________________
Reason for Leaving ___________________________________________________________________________________

6. Driving Experience and Qualifications
Please provide Driver Licenses and all endorsements held within the past 3 years.
License Type State Endorsements License Number Date Received Expiration Date
1. Have you ever been denied a license, permit or the privilege to operate a motor vehicle? Yes ____ No ____
2. Has any license, permit or privilege to operate a motor vehicle been suspended or revoked? Yes ____ No ____
3. Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations? Yes ____ No ____
4. If you responded “yes” to any of the questions above, please explain below:
CDL Holders Only – Do you have at least one year of verifiable tractor trailer driving experience? Yes ____ No ____
Class of Equipment Type of Equipment
(Van, tank, flat, etc.)
Dates
From To
Approximate Number
of Total Miles
List all special courses or training which will help you as a driver:
All Driver Applicants must complete:
List any Traffic Convictions, Citations and Forfeitures for the past three years other than Parking Violations:
Location Date Charge Penalty
Accident Review
Have you been involved in any work related incident(s) in the last three years which resulted in damage and/or injury to
equipment, property or persons? Yes _____ No _____ If yes, please provide date and incident information below.

7. Have you had any accidents in the last three years? Yes _____ Non _____ If yes, please provide date and incident
information below.
Dates
(Most Recent First)
Nature of Accident
(Head-on, rear-end, upset, etc.)
Injuries
Yes/No
Fatalities
Yes/No
Drug and Alcohol Testing – CDL Holders Only
Pursuant to changes effective August 1, 2001, in Part 40 of the Federal Motor Carrier Safety Regulations, this
section is being added to the driver application and should be completed by each applicant. These changes
require each motor carrier to inquire of prospective drivers the information in the question below.
Have you, the applicant, had a positive alcohol or drug test result, or refused to take a DOT drug or alcohol
pre-employment test within the past three years from a motor carrier who did not hire you? Yes _____
No _____
Applicant Must Read and Sign
I certify that I have read and understand this employment application. I agreed and understand that ECM or its agents
may investigate my background to ascertain any and all information of concern to my employment/criminal history,
whether same is of record or not. I hereby release ECM, its officers, employees, affiliates, attorneys and any other
persons named herein from all liability for any damages on account of investigating such information. I understand that
as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks
that are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of a physical
examination and/or drug test.
It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508; I have been told that this
investigation may include an Investigative Consumer Report, including information regarding my character, general
reputation, personal characteristics and mode.
I agree to furnish such additional information and complete such examinations as may be required to complete my
employment application process.
I also understand that misrepresentation or omission of information of facts may result in my rejection and/or dismissal.
It is agreed and understood that this application for employment in no way obligates the employer to employ me.
If hired, I agree to abide by all of the policies and procedures of my employer.
This certifies that 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.
Applicant Signature __________________________ Date ______________________
In compliance with 49 CFR Part 391.23, you have certain rights regarding the performance history information that will
be provided to prospective employers. 1. You have the right to review information provided by previous employers.
2. You have the right to have errors in the information corrected by the previous employer and for that previous employer

8. to re-send the corrected information to prospective employers. 3. You have the right to have a rebuttal statement
attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of
the information. 4. Drivers who have previous DOT regulated employment history in the preceding three years and wish
to review previous employer provided investigative information, must submit a written request to prospective
employers. This may be done at any time, including when applying, or as late as 30 days after being employed or being
notified of denial of employment. Prospective employers must provide this information within five business days of
receiving a written request. If prospective employers have not yet received the requested information from the previous
employer, then the five day deadline will begin when the requested safety performance history information is received.
If you have not arranged to pick up or receive the requested records within 30 days of prospective employers making
them available, prospective employers my consider you to have waived your request to review the record.
Submit Application