Worker Interview - DSA

Worker Interview

General Information

Project Name: Dowling Middle School (Lawson) - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: Commercial Mechanical, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/08/2017 12:00 AM

Alciviades Mora

Yolanda Gaines

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

Yes

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2017

08/07/2017

1.00

18.00

Pay Type

Pay Day

deductions

OSHA

Debit

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Level

Hammer

Channel Locks

Gloves

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

40.00

Other Work?

Other Training?

Experience

Certifications

None

Safety daily

4.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature