Worker Interview - DSA

Worker Interview

General Information

Project Name: Pilgrim Academy - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Baez Electrical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/06/2018 11:21 AM

Jorge Aguilar

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&190

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/01/2017

03/05/2018

10.00

25.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

60.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature