Worker Interview - DSA

Worker Interview

General Information

Project Name: Scarborough High School - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Baez Electrical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/20/2017 12:00 AM

Fernando Lujan

Yolanda Gaines

Straight time being paid because they work on private projects

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/20/2017

07/19/2017

9.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Power Tools

Hammer

Channel Locks

Hard hat

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

Safety daily

8.00

Electric

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature