1
Motor Carrier Information
§391.21(b)(1)
Company Name
Delta Advanced Trucking, Inc.
Company Address
2475 Laver Rd., Mansfield, OH 44905
USDOT Number
3847291
MC Number
MC-1284560
2
Applicant Information
§391.21(b)(2)
Last Name
Lopez
First Name
Maria
Middle Name
Elena
Date of Birth
01/04/1983
Social Security Number
XXX-XX-7831
Phone Number
707-773-6386
Email Address
marialopez@aol.com
Application Date
07/18/2025
Current Address
450 N Michigan Ave, Chicago, IL 60611
Driver Photo
Driver photo verified
Headshot on file from Delta Advanced Trucking driver records.
Position Applied For
Position
OTR Driver
Type
Full-Time
Date Available
08/15/2025
3
Residence History — Previous 3 Years
§391.21(b)(3)
| Address | City, State, ZIP | From | To |
|---|---|---|---|
| 450 N Michigan Ave | Chicago, IL 60611 | 06/2020 | Present |
| 2130 S Archer Ave, Unit 3A | Chicago, IL 60616 | 09/2016 | 05/2020 |
4
License Information
§391.21(b)(5)
| Issuing State | License Number | Class | Endorsements | Restrictions | Expiration |
|---|---|---|---|---|---|
| Illinois | IL3091126 | Class A | T, N | None | 08/22/2027 |
5
Driving Experience
§391.21(b)(6)
Tractor-Semitrailer
9 yrs
Straight Truck
3 yrs
Reefer
7 yrs
Flatbed
4 yrs
Tanker
2 yrs
Van / Dry
6 yrs
Total Miles Driven (Approximate)
~900,000 miles
6
Accident Record — Previous 3 Years
§391.21(b)(7)
| Date | Nature of Accident | Location | Fatalities | Injuries |
|---|---|---|---|---|
| No reportable accidents in the preceding 3-year period. | ||||
7
Traffic Violations & Forfeitures — Previous 3 Years
§391.21(b)(8)
| Date | Violation | Location / State | Vehicle Operated | Disposition |
|---|---|---|---|---|
| No traffic violations or forfeitures in the preceding 3-year period. | ||||
8
License Denial, Revocation, or Suspension
§391.21(b)(9)
I certify that no license, permit, or privilege to operate a motor vehicle has ever been denied, revoked, or suspended.
I have had a license, permit, or privilege denied, revoked, or suspended. Details are provided below:
Details (if applicable)
N/A
9
Employment History — Previous 10 Years
§391.21(b)(10)
Employer Name
Windy City Logistics, Inc.
Employer Address
4400 W 47th St, Chicago, IL 60632
Phone
773-284-5100
Position Held
OTR Driver
From
02/2020
To
07/2025
Reason for Leaving
Seeking dedicated lanes
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Prairie State Carriers, LLC
Employer Address
1100 S Canal St, Chicago, IL 60607
Phone
312-738-9200
Position Held
Regional Driver
From
08/2014
To
01/2020
Reason for Leaving
Better pay opportunity
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Heartland Express Freight
Employer Address
6250 Joliet Rd, Countryside, IL 60525
Phone
708-354-2600
Position Held
Local / P&D Driver
From
03/2009
To
07/2014
Reason for Leaving
Moved to regional role
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
10
Education
Industry Standard
| School / Institution | Location | Years Attended | Graduated? | Degree / Certificate |
|---|---|---|---|---|
| Lane Tech High School | Chicago, IL | 1997 – 2001 | Yes | High School Diploma |
| Illinois CDL Academy | Joliet, IL | 2009 | Yes | CDL Class A Certificate |
11
DOT Drug & Alcohol Testing History
§391.21(b)(10) / 49 CFR Part 40
Have you ever tested positive or refused a DOT pre-employment, random, post-accident, reasonable suspicion, return-to-duty, or follow-up drug or alcohol test with any previous employer? No
I authorize Delta Advanced Trucking, Inc. to obtain my drug and alcohol testing records from my previous DOT-regulated employers listed in Section 9, in compliance with 49 CFR §40.25.
12
Safety Performance History — Records Release Authorization
§391.23(d) / §391.53
13
Fair Credit Reporting Act Disclosure & Consent
FCRA / Industry Standard
FCRA Disclosure
In accordance with the Fair Credit Reporting Act (15 U.S.C. §1681 et seq.), Delta Advanced Trucking, Inc. may obtain a consumer report and/or investigative consumer report on you for employment purposes. This may include information about your driving record, criminal history, previous employment, education, and other relevant background information. You have the right to request disclosure of the nature and scope of any investigative consumer report and to dispute the accuracy of information contained therein.
I acknowledge receipt of the FCRA disclosure above and authorize Delta Advanced Trucking, Inc. to obtain consumer reports and/or investigative consumer reports for employment purposes.
I authorize a pre-employment background check including criminal history records and MVR from all states in which I hold or have held a license.
14
Applicant Certification & Signature
§391.21(b)(11)
Applicant Certification
I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of information on this application or any other required document may result in denial of employment or, if already employed, immediate termination. I authorize Delta Advanced Trucking, Inc. to verify all information provided and to contact all previous employers, references, and educational institutions listed herein. I understand that this application is not a contract of employment and that, if hired, my employment is at-will and may be terminated by either party at any time, with or without cause.
Maria E. Lopez
Applicant Signature
07/18/2025
Date
For Carrier Use Only
Reviewed By
T. Marchlen — Fleet Compliance
Review Date
07/19/2025
Assigned Driver ID
DRV-002
Application Status
APPROVED