Worker Interview - DSA

Worker Interview

General Information

Project Name: HSPVA - HISD

Prime Contractor: McCarthy Building Company

Subcontrctor: Comfort Systems, USA, SC.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/02/2017 12:00 AM

Jesus romero

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Welder-Structural

No

No Response

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/02/2017

08/01/2017

8.00

16.75

Pay Type

Pay Day

deductions

OSHA

Debit

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Welding torch

Clamps

Cutting Torch

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature