Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Davidson Electric Co. Inc,

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/28/2017 09:03 AM

Andrew Wilson

Victor Bowen

0

ethnicity

gender

ssn

badge

White

Male

1549

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/12/2017

11/27/2017

10.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Power Tools

Drills

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

56.00

Other Work?

Other Training?

Experience

Certifications

0

0

2.00

Boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature