Worker Interview - DSA

Worker Interview

General Information

Project Name: Scarborough High School - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Fireproof Contractors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/28/2017 12:00 AM

Carlos Yacabalquiej

Jorje Munoz

0

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Waterproofer/Caulker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/25/2017

09/27/2017

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Knife

Spatula

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

Boomlift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature