Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: Prime Contractors Inc

Subcontrctor: Bauer Sport Floor

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/06/2018 09:47 AM

Josue David

Austin Jonas

Nonej

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Unskilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/04/2018

06/04/2018

9.00

10.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Saturday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Hand Tools

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

0

None

0.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature