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
Smith
First Name
Liam
Middle Name
Patrick
Date of Birth
08/23/1964
Social Security Number
XXX-XX-9034
Phone Number
820-223-4829
Email Address
liamsmith@gmail.com
Application Date
07/11/2025
Current Address
240 Madison Ave, Toledo, OH 43604
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 |
|---|---|---|---|
| 240 Madison Ave | Toledo, OH 43604 | 05/2017 | Present |
| 1860 Airport Hwy, Apt 11 | Toledo, OH 43609 | 08/2012 | 04/2017 |
4
License Information
§391.21(b)(5)
| Issuing State | License Number | Class | Endorsements | Restrictions | Expiration |
|---|---|---|---|---|---|
| Ohio | OH9450480 | Class A | T, N, X | None | 09/15/2023 |
5
Driving Experience
§391.21(b)(6)
Tractor-Semitrailer
22 yrs
Straight Truck
6 yrs
Tanker
14 yrs
Hazmat
10 yrs
Flatbed
12 yrs
Reefer
15 yrs
Total Miles Driven (Approximate)
~2,200,000 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 |
|---|---|---|---|---|
| 02/11/2024 | Speeding — 12 mph over posted limit | I-75, Wood Co., OH | Tractor-Semitrailer | Paid / Closed |
| 08/30/2023 | Failure to obey traffic signal | US-24, Monroe Co., MI | 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
Toledo Trucking Co.
Employer Address
3400 Hagman Rd, Toledo, OH 43612
Phone
419-476-8800
Position Held
OTR / Hazmat Driver
From
09/2017
To
07/2025
Reason for Leaving
Seeking dedicated account
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Northwest Ohio Carriers
Employer Address
1500 Airport Hwy, Toledo, OH 43609
Phone
419-381-4200
Position Held
Regional Driver
From
03/2011
To
08/2017
Reason for Leaving
Better compensation
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Glass City Freight
Employer Address
600 Front St, Toledo, OH 43605
Phone
419-691-3500
Position Held
Local / P&D Driver
From
06/2003
To
02/2011
Reason for Leaving
Moved to regional
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 |
|---|---|---|---|---|
| Start High School | Toledo, OH | 1978 – 1982 | Yes | High School Diploma |
| Northwest State CDL Program | Archbold, OH | 2002 | 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.
Liam P. Smith
Applicant Signature
07/11/2025
Date
For Carrier Use Only
Reviewed By
T. Marchlen — Fleet Compliance
Review Date
07/12/2025
Assigned Driver ID
DRV-008
Application Status
APPROVED