Worker Interview - DSA

Worker Interview

General Information

Project Name: Pilgrim Academy - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: iWorks Personnel

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/23/2018 10:22 AM

Anthony Johnson

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Black

Male

=CHAR(048)&913

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Unskilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/23/2018

02/23/2018

8.00

8.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Shovel

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

Fork lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature