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
Tanaka
First Name
Kenji
Middle Name
Hiro
Date of Birth
10/18/1966
Social Security Number
XXX-XX-8412
Phone Number
871-429-6220
Email Address
ktanaka@yahoo.com
Application Date
07/10/2025
Current Address
115 E Broad St, Columbus, OH 43215
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
08/01/2025
3
Residence History — Previous 3 Years
§391.21(b)(3)
| Address | City, State, ZIP | From | To |
|---|---|---|---|
| 115 E Broad St | Columbus, OH 43215 | 04/2018 | Present |
| 960 Bryden Rd, Apt 2 | Columbus, OH 43205 | 06/2014 | 03/2018 |
4
License Information
§391.21(b)(5)
| Issuing State | License Number | Class | Endorsements | Restrictions | Expiration |
|---|---|---|---|---|---|
| Ohio | OH2779041 | Class A | T, N, H | None | 06/10/2024 |
5
Driving Experience
§391.21(b)(6)
Tractor-Semitrailer
18 yrs
Straight Truck
6 yrs
Tanker
10 yrs
Hazmat
8 yrs
Reefer
12 yrs
Flatbed
7 yrs
Total Miles Driven (Approximate)
~1,800,000 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 |
|---|---|---|---|---|
| 09/04/2024 | Following too closely | I-71, Franklin Co., OH | Tractor-Semitrailer | Paid / Closed |
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
Central Ohio Transport, LLC
Employer Address
2600 Westbelt Dr, Columbus, OH 43228
Phone
614-878-5500
Position Held
OTR / Hazmat Driver
From
07/2018
To
07/2025
Reason for Leaving
Seeking new opportunity
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Buckeye Tanker Lines
Employer Address
1400 Alum Creek Dr, Columbus, OH 43209
Phone
614-252-7700
Position Held
Regional Tanker Driver
From
01/2012
To
06/2018
Reason for Leaving
Route reassignment
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Columbus Freight Services
Employer Address
4700 Groveport Rd, Columbus, OH 43232
Phone
614-836-3200
Position Held
Local Driver
From
09/2005
To
12/2011
Reason for Leaving
Moved to tanker division
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 |
|---|---|---|---|---|
| Eastmoor Academy | Columbus, OH | 1980 – 1984 | Yes | High School Diploma |
| Columbus State CDL Program | Columbus, OH | 2005 | Yes | CDL Class A Certificate |
| NTTC Hazmat Certification | Arlington, VA (online) | 2012 | Yes | Hazmat Endorsement 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.
Kenji H. Tanaka
Applicant Signature
07/10/2025
Date
For Carrier Use Only
Reviewed By
T. Marchlen — Fleet Compliance
Review Date
07/11/2025
Assigned Driver ID
DRV-005
Application Status
APPROVED