Worker Interview - DSA

Worker Interview

General Information

Project Name: Yates High School - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: L. V. Industries Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/11/2017 12:00 AM

Allen Leal

Yolanda Gaines

PWI

ethnicity

gender

ssn

badge

Hispanic

Male

1234

Yes

Job Classification

Union Member?

Apprentice?

Period

Electronic Data

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/11/2017

07/11/2017

9.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Clam Shells

Channel Locks

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

Safety daily

2.00

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature