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2.b James Gribble_Wastewater Committee ApplicationCommittee or Commission Application Name *Address * Phone *Email * Residency * Committee or Committee * Have you served on any Scandia Committee or Commission in the past?* Experience Special Interests Volunteer History Optional In accordance with M.S. 13.04 Subd. 2 we must inform you of your rights as a subject of government data. The information you give us about yourself is needed to identify you and assist in determining your suitability for the positions(s) for which you are applying. The information that we collect about you is classified as either Public or Private. Public means that it is available to anyone who asks to see it. Private means that the information is available only to the person the information is about and to the staff who must use it in the normal course of conducting City business and as otherwise provided for by law. James Gribble PO Box 33, Marine on St Croix MN 55047 ( 23 years How long have you been a resident of Scandia? Select the Committee you are applying to: Capital Investment Committee EDA (Economic Development Authority) Internet Action Committee Parks and Recreation Committee Planning Commission Sister City Committee Tourism Committee Waste & Recycling Committee Wastewater Committee Yes No List any governmental, service organizations, or professional activities which you have been or currently are involved in: I have served in government for 33 years, working for cities, counties, and the federal government. I worked in Law Enforcement with Washington County Sheriffs' Office, In the Coast Guard, was assigned environmental protection duties, as well as disaster recovery, Search and rescue. I have worked for Hubbard County Public works, mostly in storm water mitigation and roadway maintenance, I also have experience with pipeline construction and maintenance. List any of your special interests, activities or hobbies which you have that would apply to this committee: While in is not a 'hobby' I am well versed and interested in wastewater control and treatment. Much of our ecology is dependent on thoughtful and judicious use of our resources to ensure we provide a safe and healthy environment for future generations. In what volunteer activities have you participated? What was your role? I have been involved with a lake association doing clean-ups and fish counts, I volunteered taking handicapped people canoeing and camping. I also volunteered with an environmental group focused on preparing for oil spills or other disasters that would impact the areas waterways. You may attach a resume. The selection process will vary according to the number of applicants and vacancies. Your application will be kept on file for one year. By entering my full name, I am affixing my signature to this application and acknowledging that an investigation may be conducted for use in determining my qualifications. I hereby expressly authorize release of any and all information which any organization, company or person may have, including information of a confidential or privileged nature. I hereby release the City and any organization, company or person furnishing information to the City, as expressly authorized above, from any liability for damage which may result from furnishing the information requested. Signature *James Gribble Typing your name in the box will be considered an electronic signature