Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: TAG Electric Company, L.P.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/10/2017 12:00 AM

Eric Dane baggett

Victor Bowen

0

ethnicity

gender

ssn

badge

White

Male

=CHAR(048)&744

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/12/2017

11/09/2017

8.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Power Tools

Hand Tools

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

38.00

Other Work?

Other Training?

Experience

Certifications

0

0

11.00

Scissor boom rigging confined space

Aware of Postings?

Threatened?

Yes

Yes

Signatures

Employee Signature

Auditor Signature