Worker Interview - DSA

Worker Interview

General Information

Project Name: HSLECJ - HISD

Prime Contractor: B3Ci (JV BETWEEN BALFOUR BEATTY & 3Ci CONSTRUCTION)

Subcontrctor: A-1 Construction Services

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/12/2018 02:47 PM

Stephen Parkes

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Black

Male

6908

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Finisher/Cement Mason

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/12/2018

03/09/2018

8.00

13.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Saw Saw

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

1.50

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature