Worker Interview - DSA

Worker Interview

General Information

Project Name: Eastwood Academy - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: MLN Fire Protection

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/19/2018 01:28 PM

Giovanni Guevara

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

7072

No

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/03/2018

07/18/2018

8.00

19.00

Pay Type

Pay Day

deductions

OSHA

Debit

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Power Tools

Wrench

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

24.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

Scissor lift, cpr

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature