Worker Interview - DSA

Worker Interview

General Information

Project Name: Worthing High School (Phase II) - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: DTA Electric

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/08/2017 12:00 AM

Alexis blanco

Victor Bowen

0

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/02/2017

11/07/2017

8.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Screwdriver

Hand Tools

Hammer

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

48.00

Other Work?

Other Training?

Experience

Certifications

0

0

0.00

0

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature