Worker Interview - DSA

Worker Interview

General Information

Project Name: Worthing High School (Phase II) - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: Texas Premier Drywall Systems, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/09/2018 11:12 AM

Jose Garcia jr.

Lionel Blackwell

Paid weekly cash

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Drywall Hanger

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/01/2018

05/08/2018

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Cash

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Drills

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

20.00

Other Work?

Other Training?

Experience

Certifications

None

None

1.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature