NOMAC DRILLING CORPORATION COVER SHEET FOR APPLICATIONS/ PHONE CALLS Date: _________________ Should application be kept over 60 days? Yes _________ No ___________ (for Office use only) Name: ____________________________________________________________________________________ Street Address: _____________________________________________________________________________ City: ______________________________________ State: _____________ Zip Code: _________________ Phone Number: _________________________________Alt. Number: ________________________________ Number of years/months drilling experience: _____________________________________________________ Type of rig worked on: Compound __________________ Double ____________________ Diesel/Electric ___________________ Triple _________________________ Position desired: 1. _________________________________ 2. ______________________________________ Area Desired: ____________________________________________________ Rig Number: ______________ Referred by: ________________________________________________________________________________ Interviewer’s comments/remarks and signature: ___________________________________________________ Faxed In by: ___________________________________________________________________________ Print Name NOMAC DRILLING CORPORATION P.O. Box 54560 Oklahoma City, OK 73154-1560 El Reno Office 3400 S. Radio Rd. El Reno, OK 73036 Phone: 405-422-2754 Fax: 405-422-2750 Waynoka Office East Hwy 281, Rt. 1 Box 5A Waynoka, OK 73860 Phone: 580-824-7251 Fax: 580-824-0004 APPLICATION FOR EMPLOYMENT Applicants are considered for all positions without regard to race, disability, religion, sex, national origin, age or any other consideration unlawful by federal, state or local laws. Job applicants will only be considered active for 60 days, after which the individual must reapply for further consideration. APPLICANTS MAY REQUEST ANY NEEDED ACCOMMODATION TO PARTICIPATE IN THE APPLICATION PROCESS. For example an applicant may require assistance in filling out the application form, participating in the job interview, or a job demonstration. Position(s) applied for: _____________________________________________ Rig # ____________Date: __________________ Name: __________________________________________________________________________________________________ Phone: _____________________________________ Cell/Alternate Phone #: ________________________________________ Address:_________________________________________________________________How Long:______________________ (Street) (City) (State & Zip) Address (es): ______________________________________________________________How Long: ______________________ For Past Three Years_______________________________________________________________ How Long: _____________________ Have you filed an application here before? __________ If yes, give date & location ____________________________________ Have you worked for this Company before? _________ Where? ___________________Dates: ___________________________ Position: ________________________________________________________________________________________________ Are you employed now? ________________May we contact your present employer? ________________________________ What date would you be available for work? __________________ Rate of pay expected? _____________________________ Are you available to work: _______________Full Time _____________ Part Time ___________Temporary Are you 18 years or older? _________________________________________________________________________________ Have you been convicted of a felony within the last 7 years?_______________________________________________________ (Conviction will not necessarily disqualify applicant from employment) If yes, please explain: ______________________________________________________________________________________ Are you able to perform the task indicated on the attached Job Description, with or without accommodations? How would you perform the task indicated on the attached Job Description, and with what accommodations? Nomac Drilling Corporation EMPLOYERS FOR THE LAST 10 YEARS (Start with most current employer) Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Nomac Drilling Corporation EMPLOYERS FOR THE LAST 10 YEARS (Start with most current employer) Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Employer: _________________________________________________________Supervisor: ___________________________ Address: __________________________________________________________Telephone #: __________________________ Dates worked: From ____________________ to: _________________________Position held: _________________________ Description of Duties: _____________________________________________________________________________________ Reason for Leaving: _______________________________________________________________________________________ Nomac Drilling Corporation MILITARY STATUS Have you served in the US Armed Forces? __________________________Branch: _________________________________ Dates from: _________________________________________________to: ________________________________________ Rank at Discharge: ___________________________________________ Date of Discharge:___________________________ EDUCATION Circle Highest Grade Completed: 1 2 3 4 5 6 7 8 9 10 11 12 College: 1 2 3 4 Last School Attended: __________________________________________________________________________ (Name) (City & State) TO BE READ AND SIGNED BY APPLICANT I understand that, if I am hired, my employment can be terminated at any time, with or without cause, and with or without notice at the option of either the Company or myself. It is agreed and understood that should Nomac Drilling Corporation employ me, and it is later discovered I have omitted or falsified any fact in the Employment application or any other Company record; I am subject to immediate termination. It is agreed and understood that the employer or his agents may investigate the applicant’s background to ascertain any and all information permitted under Federal, State, or local laws. Whether the same is of record or not, and applicant releases the employer and agents from all liability for any damages on account of his furnishing such information. The applicant agrees to furnish such additional information and complete examinations or testing, as may be required to complete his employment file. It is agreed and understood that this application for employment in no way obligates Nomac Drilling Corporation, to employ the applicant. This certifies I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. I also certify that I have read, or had read to me, the above policy statement. ___________________________________________________ Applicant Signature _________________________ Date WORKSITE EVALUATION COMPANY: NOMAC DRILLING CORPORATION JOB: FLOOR HAND – Chainhand, Lead Tong hand, Motorman JOB & TASK DESCRIPTION There are two to three floor hand positions. Chain hand, Lead Tong hand and Motorman. Each must daily inspect the tongs, breakout line, snub lines, and dong dies for damage, excessive wear, fraying, oil soaks, etc and keep them safe and in good repair. During normal drilling operations, duties include washing, cleaning, mechanical repairs, digging ditches, drill pipe connections, drill pipe trips and other manual handling and/or maintenance activities as required by operational needs. The Motorman’s primary responsibility is to take care of all the motors on the rig. He must have a mechanical mind and the ability to trouble shoot and identify and repair minor problems that arise. He is responsible for checking the oil, oil pressure, temperature, fuel pressure and radiator water level and to record his findings in the daily engine report during his shift. The Chain hand must be adept at pulling, wrapping and throwing the chain at a continuously fast pace while going into the hole or chaining out of the hole. This activity involves throwing a chain loop around a joint of pope. The operation is performed between waist and shoulder level and could be repeated as many as 80-100 times per 12-hour shift. While tripping, the Lead Tong hand must pull and install the bushing assembly. This activity will include lifting the tongs and lateral movement of the tongs to attach them to the drill pope. The tongs are on counterweights and the exertion required to lift them would vary but is estimated to be similar to lifting a weight between 10-30 pounds. The lifting range up or down is 1-2 feet in the area of the waist. The activity is repeated and could be performed as many as 175 times in a 12-hour shift. Another activity conducted between tong usage is “pulling the slips”. This activity is performed by 2 or 3 men (depending on crew size) and could be conducted as many as 175 times per 12-hour shift. The slips weight between 100 and 175 pounds and the weight would be distributed between the 2 or 3 employees. The slips are located at floor level and would be lifted a distance of 18-24 inches. Stacking pip is another function performed by one of the floor hands during a drill pipe trip and involves manually pushing a suspended length of pipe to the area where it is stacked. The reverse activity involves restraining the suspended pipe and guiding it across the rig floor. This activity is performed in the standing position and could be performed as many as 100 times per 12-hour shift. Tripping the pipe string. This operation involves removing all of the pipe from the well bore and stacking it in the derrick. The pipe may be removed for various reasons, but usually to replace a drill bit on the end of the drill string. After the operation is complete, the pipe is “tripped” back into the well bore. The tripping operations vary depending on the depth of the well and other factors. Employees may be involved in the tripping operation for the full 12 hours of their work shift. The Floor hand is responsible for catching and cleaning samples of formation cuttings while drilling. If drilling in gas, he must keep the flare bucket burning. At times it is necessary for the floor hand to climb up in the derrick and assist the derrick hand such as hanging the belly board or bridling up or bridling down. He must also be able to go up and grease the traveling blocks and bridle line sheaves. All hands working together must keep the rig clean, picked up and free of safety hazards. It is necessary that every hand me mentally alert and physically fit during his tour. LIFT TYPE MAX LOAD PUSH/PULL 50# FLOOR TO WAIST 100# CARRY 100# TOTAL FREQUENCY 20-175 8-10 8-10 HRS/DAY 12 12 12 POSTURE/ACTIVITY STANDING CLIMBING % OF TOTAL WORK TIME 100% 35% 25-50 STEPS (Up & Down approximately 12 times @ shift) Primary duties of this position require maximum level of physical activity. The employee must be able to tolerate 12 hours standing, climbing, lifting, pulling, pushing and carrying weights of up to 100 lbs. The work is performed outside with prolonged exposure to the environment, both hot and cold. Operations could also involve prolonged exposure to wet or damp conditions i.e., working in rain, snow and sleet. Muscle groups include: Quadriceps, Low Back Extensors, Hip Extensors, Abdominal, Latissimus Dorsi, Deltoid, Pectoralis, and Hand Grip. WORKSITE EVALUATION COMPANY: NOMAC DRILLING CORPORATION JOB: MOTOR HAND JOB & TASK DESCRIPTION The motorman’s primary responsibility is to take care of all the motors on the rig. He must have a mechanical mind and the ability to trouble shoot and identify and repair minor problems that arise. He is responsible for checking the oil, oil pressure, temperature, fuel pressure and radiator water level and to record his finding is the daily engine report during his tour. Other responsibilities include racking pipe on the racking floor when coming out of the hole and fill the pipe when going in the hole. He is responsible for operation of the closing unit when shutting in the well. LIFT TYPE MAX LOAD PUSH 50# PULL 50# FLOOR TO SHOULDER 100# CARRY 100# TOTAL FREQUENCY 20-50 20-50 HRS/DAY 12 12 POSTURE/ACTIVITY STANDING KNEELING CLIMBING % OF TOTAL WORK TIME 80% 15% 35% 25-50 STEPS (Up & Down approximately 12 times @ shift) Primary duties of this position require maximum level of physical activity. The employ must be able to tolerate 12 hours standing, climbing, lifting, pulling, pushing, and carrying weights of up to 100 lbs. Also he must be able to tolerate extreme ambient temperate of heat and cold. Muscle groups include: Quadriceps, Low Back Extensor, Hamstrings, Hip Extensor, Abdominal, Latissimus Dorsi, Deltoid, Pectoralis, and Hand Grip. WORKSITE EVALUATION COMPANY: NOMAC DRILLING CORPORATION JOB: DERRICK HAND JOB & TASK DESCRIPTION The crewmember whose workstation is in the derrick while the drill pipe is being hoisted or lowered into the hole. He attaches the elevators to the stands of drill pipe while the pipe is being lowered into the hole and detaches the elevators and racks the pipe while the pipe is being hoisted out of the hole. Both operations involve the use of the arms and upper body to hold or pull the pipe. Force is exerted against the safety belt and line during the pulling and holding of the pipe. This operation could be repeated as many as 80-100 times during a 12-hour shift. He is responsible for greasing and inspecting the crown and all sheaves in the derrick. Other responsibilities include mixing of chemicals. The chemicals are packaged in paper bags and plastic buckets. The packages vary in weight from 20 to 80 pounds. Lifting and carrying is required to get the materials from the storage area to mixing areas. Manual handling of the packages or bags, could require lifting from floor level to levels between 36 and 42 inches high. Unusual circumstance might require the lifting of numerous bags during an 8-hour shift. He is also responsible for watching the mud pits for an increase or decrease in mud volume, mud weight, changes in funnel viscosity and gas cut mud. He must also watch and list to the mud pumps to know when there is a problem. LIFT TYPE PUSH/PULL FLOOR TO 42” CARRY MAX LOAD 50# 100# 100# POSTURE/ACTIVITY STANDING CLIMBING TOTAL FREQUENCY 20-175 10-20 10-20 HRS/DAY 12 12 12 % OF TOTAL WORK TIME 99% 35% 25-50 STEPS (Up & Down approximately 12 times @ shift) Primary duties of this position require maximum level physical activity. The employee must be able to tolerate 12 hours standing, climbing, lifting, pulling, pushing, and carrying weights of up to 100 lbs. The work is performed outside with prolonged exposure to the environment, both hot and cold. Operations could also involve prolonged exposure to wet or damp conditions i.e., working in rain, snow and sleet. Muscle groups include: Quadriceps, Low Back Extensors, Hamstrings, Hip Extensors, Abdominal, Latissimus Dorsi, Deltoid, Pectoralis, and Hand Grip. WORKSITE EVALUATION COMPANY: NOMAC DRILLING CORPORATION JOB: DRILLER JOB & TASK DESCRIPTION The Driller (crew foreman) is directly responsible for the rig crew during normal operations. He must be able to perform any job on the rig required of his hands in order to instruct his crew on the “how to” procedure or to fill in as a floorman as necessary. He must know the safe operating limits of the rig and keep within those bounds. He is responsible for the operation of drilling and hoisting equipment. Actual rig operations involve the use of both hands and feet to operate controls. The driller must be able to see gauges and dials at distances between 1 to 10 feet. He must be able to see the derrick man at a distance of 60 to 90 feet away. He must be mentally alert at all times to the operations taking place and crew participation. LIFT TYPE MAX LOAD FLOOR TO WAIST 100# CARRY 100# TOTAL FREQUENCY 8-10 8-10 HRS/DAY 12 12 POSTURE/ACTIVITY STANDING CLIMBING % OF TOTAL WORK TIME 100% 35% 25-50 STEPS (Up & Down approximately 12 times @ shift) Primary duties of this position require maximum level of physical activity. The employee must be able to tolerate 12 hours standing, climbing, lifting, pulling, pushing and carrying weights of up to 100 lbs. The work is performed outside with prolonged exposure to the environment, both hot and cold. Operations could also involve prolonged exposure to wet or damp conditions, i.e., working in rain, sleet or snow. Muscle groups include: Quadriceps, Low Back Extensors, Hamstrings, Hip Extensors, Abdominal, Latissimus Dorsi, Deltoid, Pectoralis, and Hand Grip.