Worker Interview - DSA

Worker Interview

General Information

Project Name: Scarborough High School - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Choate USA

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/07/2018 03:08 PM

Mario Hernandez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Landscape Laborer Skilled

No

Unkown

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/07/2018

03/07/2018

10.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Tuesday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Saw Saw

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

9.00

Other Work?

Other Training?

Experience

Certifications

None

None

7.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature