Worker Interview - DSA

Worker Interview

General Information

Project Name: Pilgrim Academy - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Mesa Mechanical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/04/2018 02:45 PM

Pedro morales

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

HVAC Installer/Mechanic

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/02/2018

04/03/2018

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Tape Measure

Hand Tools

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

0

None

4.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature