Worker Interview - DSA

Worker Interview

General Information

Project Name: Pilgrim Academy - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Baez Electrical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/14/2018 02:42 PM

Edwin Gonzalez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

5576

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/22/2018

05/11/2018

8.00

30.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hand Tools

Saw Saw

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

65.00

Other Work?

Other Training?

Experience

Certifications

None

None

19.00

Scissor shotgun

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature