WORK SKILLS REPORT

Work Report Form for Download and Print

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General Construction
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Excavation-Grading-Backfilling-Compaction

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Elevation Control - Measurement- Grade Checking-Lay-Out

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Underground Utility Lines / Trenching-Shoring / Pipelaying / Tunneling

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Concrete Formwork

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Concrete Placement/Finishing / Asphalt Paving

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Unloading-Stockpiling-Distribution of Materials / Mixing of Materials / Clean-Up

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Demolition

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Tools & Equipment
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Electric-Gasoline-Pneumatic Power Tools

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Power Equipment

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Scaffolding

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Cutting Torch / Welding

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Safety
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Work Zone Safety-Flagging-Traffic Control

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Asbestos-Lead-Rad-Hazardous Waste Abatement

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Selection-Use of Personnel Protective Equipment / Material Safety Data Sheets / Safety-Health Regulations

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TOTAL HOURS PER DAY

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First & Last Name Enter Apprentice Name Last 4 of SSN: Enter last 4 of SSN in the format XXXX TOTAL HOURS FOR THE MONTH Enter hours
ADDRESS: Enter Address CITY: Enter City STATE: Enter State
Zip Code: Enter Zip Code WAGE RATE AT END OF MONTH($):  Enter Wage DATE FORM COMPLETED: Enter Date
CONTRACTOR:  Enter Contractor JOB LOCATION AT END OF MONTH:  Enter Job Location Email address: Enter Email
HOME PHONE: Enter Home Phone in the format: (XXX)XXX-XXX CELL PHONE Enter Cell Phone in the format: (XXX)XXX-XXX
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LABORERS' LOCAL 42

301 South Ewing Avenue
St. Louis, MO 63103
Phone: 314.531.1187
Email: laborers@local42.us
Website: www.liuna42stl.com

LABORERS' LOCAL 110

4532 South Lindbergh Boulevard
St. Louis, MO 63127
Phone: 314.892.0777
Email: sschwartz@lu110.com
Website: www.lu110.com

LABORERS' LOCAL 660

1320 South Callahan Road
Wentzville, MO 63385t
Phone: 636.946.8766
Email: sarah@laborers660.org
Website: www.liuna660.com

LABORERS' LOCAL 662

209 Flora
Jefferson City, MO 65101
Phone: 573-635-1441
Email: laborers662@gmail.com
Website: www.liuna662.com

LABORERS' LOCAL 840

10760 County Road 2000 (North Y)
Rolla, MO 65401
Phone: 573.364.3928
Email: laborerslocal840@gmail.com
Website: www.liuna840.com

LABORERS' LOCAL 955

404 Tiger Lane
Columbia, MO 65202
Phone: 573.499.3720
Email: laborers955@gmail.com
Website: www.liuna955.com

LABORERS' LOCAL 1104

773 Enterprise
Cape Girardeau, MO 63703
Phone: 573.334.7722
Email: local@laborers1104.org
Website: www.liuna1104.com