Tideline Staffing Example Electronic Tickets
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www.TidelineStaffing.comTo avoid disciplinary action, it is the supervisor and employee’s responsibility to report ALL incidents immediately.
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Phone: (239)208-3907
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Fax: (772)360-1283Severe injuries call 9-1-1.
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Supervisor on site:Driver:
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W/E Date
2/27/2019
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Customer Name:
Tideline Staffing Customer
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2/212/222/232/242/252/262/27
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LAST, FIRST NAMEMonday
Tuesday
Wednsday
ThursdayFriday
Saturday
SundayHours*
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1Employee #188881042
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2Employee #288881042
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3Employee #388881042
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40
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50
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60
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70
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80
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90
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100
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110
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120
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130
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140
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150
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160
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170
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180
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190
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200
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210
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220
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230
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240
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250
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*Minimum 4 hours per worker
Total126
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Supervisor Signature
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The customer agrees to supervise all employees of Tideline Staffing at all times. Said employees will not be
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permitted to operate unprotected or dangerous equipment, to perform on ladders, scaffolds or rooftops, to perform
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excavation without proper shoring, or to work under any unsafe conditions.
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