Worker Interview - DSA

Worker Interview

General Information

Project Name: Pilgrim Academy - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Sheffield Acoustical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/11/2018 02:29 PM

Carl Carter

Lionel Blackwell

None

ethnicity

gender

ssn

badge

White

Male

8889

No

Job Classification

Union Member?

Apprentice?

Period

Ceiling Tile Installer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/01/2018

04/10/2018

5.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Snips

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

40.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature