Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: Prime Contractors Inc

Subcontrctor: Prime Contractors Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/16/2018 10:13 AM

Luis Rodriguez

Austin Jonas

Gets paid 200-300/day. Not hourly

ethnicity

gender

ssn

badge

Hispanic

Male

7378

Yes

Job Classification

Union Member?

Apprentice?

Period

Terrazzo Grinder

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/07/2018

05/15/2018

9.00

200.00

Pay Type

Pay Day

deductions

OSHA

Debit

Thursday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Caulker

Clam Shells

Clamps

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

54.00

Other Work?

Other Training?

Experience

Certifications

No

None

17.00

No

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature