Worker Interview - DSA

Worker Interview

General Information

Project Name: HSLECJ - HISD

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

Subcontrctor: TAS Commercial Concrete Construction, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/26/2018 11:31 AM

Alejandro Moreno

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

3019

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/01/2017

03/23/2018

8.00

15.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Hammer

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

Yes

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

35.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature