Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: Prime Contractors Inc

Subcontrctor: Hi-Tek Sound & Signal, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/16/2018 10:14 AM

Miguel Lugo

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

8788

No

Job Classification

Union Member?

Apprentice?

Period

Electronic Data

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/01/2018

05/15/2018

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Clamps

Wrench

Nine

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

Cameras, tech

No

5.00

Fire alarm certified

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature