Worker Interview - DSA

Worker Interview

General Information

Project Name: Worthing High School (Phase II) - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: Metal Specialties

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/01/2018 03:09 PM

Emanuel molina

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Sheetmetal Worker-Roofing

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/02/2018

04/30/2018

9.00

14.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Power Tools

Drills

Snips

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

43.00

Other Work?

Other Training?

Experience

Certifications

None

None

13.00

Scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature