Worker Interview - DSA

Worker Interview

General Information

Project Name: Eastwood Academy - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: Tejas Electrical Services, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/28/2018 02:06 PM

Gonzalo ayala

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

3174

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/27/2018

06/27/2018

8.00

19.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Screwdriver

Hand Tools

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

6.00

Scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature