Worker Interview - DSA

Worker Interview

General Information

Project Name: HSPVA - HISD

Prime Contractor: McCarthy Building Company

Subcontrctor: Prism Electric, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/18/2017 12:00 AM

Oscar Ortiz

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

3990

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/17/2017

07/17/2017

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hammer

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

8.00

Scissor boom

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature