2014 TJ Evaluation

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T/J INSPECTION, INC.910 NW 139th Street Parkway

Edmond, OK 73013 405-285-2760

Fax 405-285-2793

Name (as it appears on your resume)Permanent Mailing City, State, ZipCell PhoneHome PhoneEmail AddressFax Today’s Date

Are you currently working in pipeline?

City and State your project is located?

Have you ever worked as an inspector?

If so, how long?

What Inspection Companies you have worked for? Please list:

Your estimated date of availability?

Are you willing to work for any oil and gas company?If no, please state whom and whyIs there a specific company you prefer to work for? If yes, please state the company

When working out of town you prefer

Yes No

Yes No

Yes No

Yes No

Travel Trailer Motel/Hotel

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Job Descriptions- Using a scale from 1-5

Mainline *(Please attach any certifications that may apply)Project ManagerChiefConstruction CoordinatorProject CoordinatorAssistant ChiefOffice ManagerMaterial / Expeditor Welding Inspector * CWI, AWS/CWI Number:

Fabrication Fire line Cold Tie-In (New Construction) Hot Tie-In Stopples/Hot Tap

Utility Inspector Right Of Way Ditching Sandblasting Coating Painting Hydro Testing Cement Fence Stringing Bending Lowering- In Backfilling Clean Up

Distribution Jurisdictional

DOT Were you responsible for the closing packet? Directional BoresConventional BoresSafety InspectorMetering Stations Weld MapsAs Built DrawingsDrafterRedlinesOther (Comments below)

Poly Steel

Yes No

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Please rate your experience: 5 being most experienced and 1 being minimally experienced. There are two categories; Mainline and Well Connects that you need to rate your experience in each position held. Please answer appropriately to better place you in the field

Well Connects *(Please attach any certifications that may apply)Project ManagerChiefConstruction CoordinatorProject CoordinatorAssistant ChiefOffice ManagerMaterial / Expeditor Welding Inspector * CWI,AWS/CWI Number:

Fabrication Fire line Cold Tie-In (New Construction) Hot Tie-In Stopples/Hot Tap

Utility Inspector Right Of Way Ditching Sandblasting Coating Painting Hydro Testing Cement Fence Stringing Bending Lowering- In Backfilling Clean Up

Distribution Jurisdictional

DOT Were you responsible for the closing packet? Directional BoresConventional BoresSafety InspectorMetering Stations Weld MapsAs Built DrawingsDrafter

RedlinesOther (Comments below)

Poly Steel

Yes No

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Integrity / Multiple Dig Sites Program Project ManagerChiefDig Site InspectorMaterial / ExpeditorDocumentation / Office Manager Bending InspectorHydro TestingSmart Pig Runs

Type of Integrity / Line RepairsCut- OutsClock SpringsSleevesMulti Dig SitesStopplesOther (Comments below)

Plant/RefineryChiefCivil InspectionSandblastingPainting

Mechanical Inspection

Coating

Electrical (Plant/ Compression) Other (Comments below)

Tanks / Vessels Truck Racks

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Global Positing System/ Geographical Information System

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GPS (Points)GIS (Mapping Skills)Auto CADSurvey (Details / List State and License)Computer Skills

Other (Comments below)

Crane Operations/ Certifications *(Please attach any certifications that may apply)Offshore/OnshoreCertifications*Brief Description

Years of Experience

_____________Dirt Work on Compressor Station or any other type

Please mark the types of products you are familiar working with EthanolLiquidsNatural GasMethaneEthane

Iso Butane OtherAsimac Butane OtherPropane OtherGasoline OtherDiesel Liquid Spill

Please mark the category in which you feel you have the most experience and the one you prefer

MainlineWell ConnectsPlantCompressionR/W

Sandblasting & Coating - Painting

Distribution _______ FabricationEnvironmental _______ Measuring StationsIntegrity _______ Meter RunsGPS/Survey _______ Poly

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Please mark the company(s) that your OQ’s are currently throughNCCERMEAEWebOQVeriforceOthers

In your estimation, when were your OQ’s last updated?

Social Security Number: For processing quickly, otherwise we have to wait to process if you are considered for hire

Do you have a current driver’s license?

Do you have a current passport?

Are eligible for passport? (Canadian work requires it)

Certifications *(Please attach any certifications that may apply) OSHA 30*OSHA 8hr Excavation*NACE Certified/Corrosion Inspector*NDT Technician Level 1, 2, or 3 (please circle)*Hazwoper *Certified Ultrasonic TesterAPI 510 Pressure Vessel InspectorAPI 570 Piping InspectorAPI 653 Aboveground Storage Tank InspectorASME B31.1 Power PipingASME B31.3 Process PipingAWS/CWI Cert No: * Crane Certifications:Other Certifications:

Yes No

Yes No

Yes No

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In the box below, please mark the Inspector Field Tools that you have for personal use. All of our clients require 1 or more of the tools listed below. If you do NOT have the tools that are required for the job, then you will be responsible to purchase the tools that are required for that particular job. If you choose NOT to purchase the required tools then you will NOT be able to work for that client.

Inspector’s Field ToolsMulti Gas Monitor - Purchase from grainger.com, discountsafetygear.com, or ebay.com100 Foot Tape Measure- (read in 10ths of an inch)- Purchase Lowe’s or hardware store25 Foot Tape Measure - any hardware storeThorpe Pit Gauge - Purchase from mesaproducts.comDigital Thermometer or Heat Gun - Lowes or any hardware storePocket Penetrometer - Purchase from labsafety.com, professionalequipment.comFRC Clothes - Purchase from Frdepot.comHard Hat - Purchase from labsafety.com or discountsafetygear.comSteel Toe Boots/Shoes Safety Glasses w/ side shieldsReflective Vest (FRC) Traffic Cones - Purchase from discountsafetygear.comWelding Tools ( AWS Inspection Kit)AMP/Volt MeterAnemometer for wind speedCoating thickness gauge - wetCoating thickness gauge - dryLevelMirror (lighted)CalipersGauss MeterStop WatchFlashlightPaints pensOrange RibbonRedbook for Daily Logs - Purchase from Office Supply StoreOther (Comments below)

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Please list any and all restrictions in order to help us successfully place you in the position that fits you best.

RestrictionsLocationsClimateLength of AssignmentType of workOther Restrictions/Medical Release:

Please list all states that you have worked in, include any terrain, climate/altitude:

Thank you for the completion of this self evaluation.

All of this is to better serve you. Please make sure this matches your resume.

2014 TJ Evaluation

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