Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: CFI Mechanical Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/11/2018 02:15 PM

Reynaldo Reyna

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

6608

No

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

Yes

Yes

3

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/01/2018

05/10/2018

8.00

24.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Wrench

Level

Channel Locks

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

49.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature