Worker Interview - DSA

Worker Interview

General Information

Project Name: HSPVA - HISD

Prime Contractor: McCarthy Building Company

Subcontrctor: Dance Floor USA

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/09/2018 01:00 PM

Jeremy Wood

Lionel Blackwell

None

ethnicity

gender

ssn

badge

White

Male

7785

No

Job Classification

Union Member?

Apprentice?

Period

Floor Layer/Finisher

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/05/2018

05/05/2018

12.00

23.05

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Saw Saw

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

12.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature