1 REVISED 10/24/2007

PRECIPITATOR SERVICES GROUP ,INC.

APPLICATION OF EMPLOYEMENT PLEASE FILL OUT ALL PAGES COMPLETELY IF YOU

DO NOT YOU WILL NOT BE CONSIDERED PERSONAL:

LAST NAME FIRST NAME MIDDLE NAME DATE

STREET ADDRESS HOME

TELEPHONE ( )

CITY STATE ZIP CELL PHONE: ( )

HAVE YOU EVER WORKED WITH PSG BEFORE? YES NO WHEN:

SOCIAL SECURITY #

POSITION DESIRED: LABORER WELDER OTHER

PAY EXPECTED

WORK DESIRED SHOP ROAD WORK

DRIVER LICENSE: YES / NO #_________________ STATE: __________

LIST ANYONE YOU KNOW THAT IS EMPLOYED WITH PSG:

DATE OF BIRTH: ____/____/____

EDUCATION: SCHOOL NAME AND

LOCATION COURSE

OF STUDY DID YOU GRADUATE?

DEGREE OR DIPLOMA

HIGH SCHOOL

YES NO

TRADE/ TECHNICAL

YES NO

COLLEGE

YES NO

IN CASE OF EMERGENCY PLEASE CONTACT : NAME: ____________________ PHONE: __________________ ADDRESS: ___________________________________ RATE OF PAY: DATE HIRED: EMPLOYEE # HIRED BY:

2 REVISED 10/24/2007

EMPLOYMENT RECORD YOU MUST FILL OUT PAGE COMPLETELY

PLEASE GIVE ACCURATE COMPLETE EMPLOYMENT RECORD. START WITH PRESENT OR MOST RECENT EMPLOYER.

COMPANY: TELEPHONE:

( ) ADDRESS:

DATE – MONTH & YEAR FROM TO

NAME OF SUPERVISOR HOURLY PAY START LAST

STATE JOB TITLE & DESCRIBE YOUR WORK:

REASON FOR LEAVING:

COMPANY: TELEPHONE:

( ) ADDRESS:

DATE – MONTH & YEAR FROM TO

NAME OF SUPERVISOR HOURLY PAY START LAST

STATE JOB TITLE & DESCRIBE YOUR WORK:

REASON FOR LEAVING:

COMPANY: TELEPHONE:

( ) ADDRESS:

DATE – MONTH & YEAR FROM TO

NAME OF SUPERVISOR HOURLY PAY START LAST

STATE JOB TITLE & DESCRIBE YOUR WORK:

REASON FOR LEAVING:

WE MAY CONTACT THE EMPLOYERS LISTED ABOVE UNLESS YOU INDICATE THOSE YOU DO NOT WANT US TO CONTACT.

DO NOT CONTACT EMPLOYER NUMBER (2) ____________REASON_____________________ __________________________________________________________________

MILITARY

DID YOU SERVE IN THE U.S. ARMED FORCES YES NO

IF “YES” IN WHAT BRANCH?

DESCRIBE ANY TRAINING RELEVANT TO THE POSITION, WHICH YOU ARE APPLYING.

3 REVISED 10/24/2007

FIELD AND MANUFACTURING EXPERIENCE

YOU MUST FILL OUT COMPLETELY

PLEASE READ CAREFULLY & GIVE ACCURATE, COMPLETE ANSWERS.

1

TYPE OF WELDING ___________________________ ______________________________________________ LENGTH OF EXPERIENCE:______________________

CERTIFIED YES NO

2 TYPE OF ELECTRICAL: COMMERCIAL INDUSTRIAL RESIDENTIAL LENGTH OF EXPERIENCE:______________________

LICENSED YES NO

3 EQUIPMENT OPERATORS: _________________________ TYPE OF EQUIPMENT ______________________________ LENGTH OF EXPERIENCE:__________________________

LICENSED YES NO

4 MACHINE/FABRICATION SHOP TYPE OF EQUIPMENT: _____________________________________________________________________________ LENGTH OF EXPERIENCE:___________________________

CERTIFICATIONS YES NO

5 BLUE PRINT INTERPRETATION:_____________________ ____________________________________________________________________________ LENGTH OF EXPERIENCE:__________________________

CERTIFICATIONS YES NO

6 RIGGING: _________________________________________ ____________________________________________________________________________ LENGTH OF EXPERIENCE:______________________

CERTIFICATIONS YES NO

7 STEEL ERECTION:_________________________________ LENGTH OF EXPERIENCE:__________________________

CERTIFICATIONS YES NO

8 PIPE FITTING: _____________________________________ ____________________________________________________________________________ ____________________________________________________________________________ LENGTH OF EXPERIENCE:__________________________

CERTIFICATIONS YES NO

9 MILLWRIGHT: _____________________________________ ____________________________________________________________________________ LENGTH OF EXPERIENCE:__________________________

CERTIFICATIONS YES NO STATE: _________________

10 OTHER QUALIFICATIONS: __________________________ ___________________________________________________ LENGTH OF EXPERIENCE:______________________

CERTIFICATIONS YES NO

4 REVISED 10/24/2007

MEDICAL INFORMATION PLEASE READ CAREFULLY & GIVE ACCURATE COMPLETE ANSWERS

IN ACCORDANCE WITH CFR (CODE OF FEDERAL REGULATIONS) 60-250 AN APPLICANT MAY IDENTIFY HIMSELF IF HE HAS A PHYSICAL MENTAL HANDICAP, OR THE APPLICANT IS A DISABLED VETERAN OR A VETERAN OF THE VIETNAM ERA. THIS INFORMATION IS VOLUNTARY, IT WILL BE KEPT CONFIDENTIAL AND WILL BE USED IN ACCORDANCE WITH THE ABOVE ACTS AND THE PRESCRIBED REGULATIONS. WE RESERVE THE RIGHT TO HAVE OUR COMPANY PHYSICIAN EXAMINE YOU UPON ANY TYPE OF INJURY.

1

PHYSICAL/MENTAL HANDICAP: YES NO IF YES DESCRIBE: _______________________________ _________________________________________________

IF YES WILL THIS AFFECT YOUR JOB PERFORMANCE YES NO

2

PHYSICAL DISABILITIES: YES NO IF YES DESCRIBE: _______________________________ _________________________________________________

IF YES WILL THIS AFFECT YOUR JOB PERFORMANCE YES NO

3

NAME OF PHYSICIAN: ___________________________ ADDRESS: _______________________________ CITY:_________________ STATE:_______ ZIP:_______

PHONE NUMBER: ( ) ______________

4

LAST EXAMINATION OR TREATMENT BY PHYSICIAN: __________________________________________________________ ILLNESS OR INJURY: _______________________________ _________________________________________________

DID YOU MISS TIME FROM WORK? YES NO DAYS OFF:__________________

5

ANY SURGICAL OPERATIONS: YES NO IF YES DESCRIBE: _______________________________ _________________________________________________ TREATING PHYSICIAN:___________________________

DID YOU MISS TIME FROM WORK? YES NO DAYS OFF:_________________

6

HAVE YOU HAD ANY INJURIES TO THE BACK OR NECK? YES NO IF YES DESCRIBE: _______________________________ _________________________________________________

DID YOU MISS TIME FROM WORK? YES NO DAYS OFF:_________________

7

HAVE YOU HAD ANY INJURIES TO THE BACK OR NECK? YES NO IF YES DESCRIBE: _______________________________ _________________________________________________ COMPANY NAME:________________________________

DID YOU MISS TIME FROM WORK? YES NO DAYS OFF:_________________

8

DESCRIBE ANY INJURIES, DISEASES, CONDITIONS OR DIAGNOSIS THAT MAY LIMIT YOUR ABILITY TO FULLY PERFORM THE POSITION FOR WHICH YOU ARE APPLYING: ____________________________________________

9 I CERTIFY THAT THE MEDICAL INFORMATION IS TRUE TO THE BEST OF MY

KNOWLEDGE AND BELIEF: SIGNATURE ____________________ DATE: ______

5 REVISED 10/24/2007

LIST OF ACCEPTABLE DOCUMENTS

LIST A LIST B LIST C DOCUMENTS THAT ESTABLISH IDENTITY AND EMPLOYMENT ELIGIBILITY

DOCUMENTS THAT ESTABLISH IDENTITY DOCUMENTS THAT ESTABLISH EMPLOYMENT ELIGIBILITY

1. U.S. Passport (unexpired or expired)

1. Driver’s license or ID card issued by a State or cutlying possession of the U.S. provided it contains a photograph or information such as name, date of birth, sex, height, eye color, and address.

1. U.S. social security card issued by the Social Security Administration (other than a card stating it is not valid for employment)

2. Certificate of Citizenship (INS Form N-560 or N-561)

2. ID card issued by federal, state, or local government agencies or entities provided it contains a photograph or information such as name, date of birth, sex , height, eye color and address.

2. Certification of birth abroad issued by the Department of State (Form FS-545 or Form DS-1350)

3. Certificate of Naturalization (INS Form N-550 or N-570)

3. School ID card with a photograph

3. Original or certified copy of a birth certificate issued by a state, county, municipal authority or cutlying possession of the U.S. bearing an official seal.

4. Unexpired foreign passport with I-551 stamp or attached INS form I-94 indicating Unexpired employment authorization

4. Voter’s registration card 4. Native American tribal document

5. Allen Registration Receipt card with photograph (INS Form I-151 or I-551)

5. U.S. Military card or draft record 5. U.S. Citizen ID Card (INS Form I-197)

6. Unexpired Temporary Resident card (INS Form I-688)

6. Military dependant’s ID card 6. ID Card for use of Resident Citizen in the U.S. (INS Form I-179)

7. Unexpired Employment Authorization Card (INS Form I-888A)

7. U.S. Coast Guard Merchant Mariner Card 7. Unexpired employment authorization document issued by the INS (other than those listed under list A)

8. Unexpired Re-entry Permit (INS Form I-327)

8. Native American tribal document

9. Unexpired Refugee travel document (INS Form I-571

9. Driver’s license issued by a Canadian government authority

10.Unexpired employment authorization document issued by the INS which contains a Photograph (INS Form I-6888)

10. School record or report card

11. Clinic, doctor, or hospital record 12. Day-care or nursery school record

6 REVISED 10/24/2007

WELCOME TO PRECIPITATOR SERVICES GROUP, INC. We are glad that you are a part of our company. To inform you of our job practices, we have prepared this list of Employee Rules and Regulations.

PLEASE READ CAREFULLY AND UNDERSTAND THEM. SIGN AT THE BOTTOM OF PAGE 7.

1. All persons hired to work at job away from the home office will be under the same guide

lines as those working in the office or fabrication facility.

2. Any persons who accept a position with PSG as an employee will be expected to perform to the expectations of their supervisors, within their job description and capabilities.

3. Your supervisor will inform you of the starting times, quitting times and the break times

for the jobsite for which you will be working at. A 30 minute unpaid lunch break will occur no later than 6-hours after the work day has begun. All employees are expected to be at their workstation ready to begin work at the start of the workday. All breaks are classified as walking breaks and 10-minutes before the end of the shift employees may start picking up tools for the end of shift. If for any reason you will not attend, or be late, or must leave early from the shift you are scheduled you must let your supervisor know as soon as possible and have it approved. You must adhere to the customers sign in/sign out requirements also.

4. ALL EMPLOYEES ARE EXPECTED TO REMAIN ON THE JOBSITE UNTIL

THE PROJECT IS COMPLETED OR THEY HAVE PERMISSION TO RETURN HOME.

5. More than two unexcused absences can result in termination.

6. Employees should take care of all material and equipment issued by the company. You

will be required to sign for all equipment, tools, etc. If the company property is not returned or is damaged due to improper treatment of the equipment. The employee authorizes the company to deduct the cost of the equipment from their paycheck.

7. All drivers must turn in maintenance reports to the DOT supervisor upon returning

vehicles. Drivers also must return vehicles at the DOT UPON ARRIVAL. Any one not returning vehicles upon arrival without approval from the DOT supervisor will be charged a rental fee of $50.00 per day until returned. The employee authorizes PSG the right to pay roll deduct this amount.

8. All maintenance records and vehicle damage reports must be turned into; in person and

approved by the DOT supervisor before any drivers will be paid.

9. NEW LAW SAYS Commercial vehicles can and will be confiscated for alcohol containers on board. Drivers are responsible to see that no alcohol is in company vehicles.

7 REVISED 10/24/2007

10. PSG is committed to providing a safe work environment, free from drug and alcohol abuse. Drug and alcohol abuse can ruin lives and have serious effects on our workplace. PSG will implement random drug testing and “testing for cause” on every job site NO ADVANCE NOTICE WILL BE GIVEN. IF YOU ARE CAUGHT WITH DRUGS OR ALCOHOL ON COMPANY PROPERTY OR JOBSITE PROPERTY YOU WILL BE TERMINATED IMMEDIATELY. This became effective December 1, 1994 and revised on November 12, 2002. Testing for cause will be done if you are involved in any kind of accident, irrespective of the cause of the accident; OR IF the supervisor believes that you may be under the influence. Anyone testing positive will be terminated, the cost of the drug test will be deducted from any money earned. In addition your name will be removed from the acceptable employee list.

11. As an employee of PSG, you are to follow any and all safety rules and regulations put

forth by this company and that of our customers. Willful , deliberate, or repeated violations of safety rules will result in termination.

12. A partial list of improper conduct, which will result in disciplinary actions including

termination follows: A. Dishonesty, including any falsification or misrepresentation, providing

incomplete, misleading, or incorrect information in connection with preparations of any company records, includes application for employment.

B. Possession, sale or use of intoxicants or drugs on company property or jobsite. C. Not achieving acceptable production standards. D. Any other conduct that is of a serious nature and which, in the sole judgments of

the company, make the employee unfit for further service or warrants discharge or discipline.

PSG, Inc is an equal opportunity employer. Employee Signature: Date ________________________________ _______________ PSG Representative: Date ________________________________ _______________

8 REVISED 10/24/2007

Each individual hired by PSG, Inc. must have working knowledge of the skill he professes to hold and be able to demonstrate that particular skill on demand. He must possess certain tools of his/her trade. If for some reason, he/she does not have the tools necessary to perform his/her craft, then PSG, Inc. is prepared to make those tools available at its cost. Other tools and equipment required to perform the work will be checked out to each individual with the requirement that all tools must be returned at the end of each shift. Tools not returned will be charged to the employee and deducted from his/her paycheck. PERSONAL ITEMS REQUIRED to be in possession of all the employees are gloves, a brown company color hardhat, SAFETY BOOTS (STEEL TOE) NO EXCEPTION, and ANSI approved safety eyewear. The following can be purchased by the employees and payroll deducted: This is not an attempt by PSG, Inc. to make a profit on supplies, but rather an attempt to stop all the waste that occurs during a project.

SIGNATURE DATE ______________________________ _______________________

9 REVISED 10/24/2007

Precipitator Services Group P.O. Box 339 Elizabethton, TN 37644

REQUEST FOR INFORMATION FROM PREVIOUS EMPLOYER FROM: Precipitator Services Group, Inc. TO : DATE: SOCIAL SECURITY NUMBER: __________________ has made application to this company for a position as a______________, And states that you employed him/her as a _________________ from ________ to __________. Will you please reply to the inquiry below respecting this applicant. Your reply will be held in strict confidence and will in no way involve you in any responsibility. For your convenience in replying by return mail, we have enclosed a stamped self addressed envelope, or you may fax this back at Fax Number (423) 543-8737. 1. Is the employment record with your company correct as stated above? ______________________________________________________________________________ 2. What kind (s) of work did the applicant do?________________________________________ 3. Reason for leaving your company: Discharged: ______ Laid Off: ______ Resigned: ______ Remarks: _____________________________________________________________________ 4. Was the applicant’s general conduct satisfactory? ___________________________________ 5. Is the applicant competent for the position sought? __________________________________

Work Habits Excellent Good Fair Poor Very Poor Quality of Work Safety Habits Personal Habits Attitude Attendance Remarks: Date Signature Title _______ ________________________ _______________ Name of Company : _________________________ APPLICANT’S SIGNATURE: ______________________________ DATE: _____________ I hereby authorize you to give Precipitator Services Group Inc. the above asked information on the named employee and you are released from any and all liability which may result from furnishing such information to the above named company.

10 REVISED 10/24/2007

I do hereby certify that I have received and read the PRECIPITATOR SERVICES GROUP, INC. substance abuse and testing policy and have had the drug-free workplace program explained to me. I understand that if my performance indicates it is necessary, I will submit to a drug and/or alcohol test. I also understand that failure to comply with a drug and/or alcohol testing request or a positive confirmed result for the illegal use of drugs and/or alcohol may lead to discipline, up to and including, termination of employment and/or loss of workers’ compensation benefits.*

*(pursuant to T.C.A. Section 50-9-100 et.seq) _________________________________________ Name of Employee (Please Print) _________________________________________ Employee’s Signature _________________________________________ Date

11 REVISED 10/24/2007

Pre-Employment Drug Testing Consent & Release Form

I hereby consent to submit to urinalysis and/or other tests as shall be determined by PRECIPITATOR SERVICES GROUP, INC. in the selection process of applicants for employment, for the purpose of determining the drug content thereof. I agree that PRECIPITATOR SERVICES GROUP, INC. may collect these specimens for these tests and may test them or forward them to a testing laboratory designated by the company for analysis. I further agree to and hereby authorize the release of the results of said tests to the company. I understand that it is the current illegal use of drugs and/or abuse of alcohol that prohibits me from being employed at this Company. I further agree to hold harmless PRECIPITATOR SERVICES GROUP, INC. and its agents (including the above named physician or clinic) from any liability arising in whole or part out of the collection of specimens, testing, and use of the information form said testing in connection with the Company’s consideration of my employment application. I further agree that a reproduced copy of this pre-employment consent and release form shall have the same force and effect as the original. I have carefully read the foregoing and fully understand it contents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been coerced into signing this document by anyone. _______________________________ ______________________ Applicant (Print Name) Social Security # _______________________________ ______________________ Applicant (Signature) Date _______________________________ Witness Printed Name _______________________________ Witness Signature