Worker Interview - DSA

Worker Interview

General Information

Project Name: Bellaire High School - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: Precision Demolition, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/02/2018 02:43 PM

Miguel M. Velasquez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/02/2018

07/02/2018

10.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

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

None

None

0.00

6

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature