Worker Interview - DSA

Worker Interview

General Information

Project Name: HSLECJ - HISD

Prime Contractor: B3Ci (JV BETWEEN BALFOUR BEATTY & 3Ci CONSTRUCTION)

Subcontrctor: Trio Electric

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/04/2017 12:00 AM

Ignacio Garcia

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

5101

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

No

Yes

4

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/04/2017

08/03/2017

8.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Drills

Saw Saw

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

48.00

Other Work?

Other Training?

Experience

Certifications

None

None

9.00

Scissor/boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature