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 03:10 PM

Darwin toro

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

No

Yes

2

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/14/2018

05/09/2018

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Drills

Power Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

44.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature