Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: Prime Contractors Inc

Subcontrctor: TX Lonestar Mechanical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/16/2018 10:34 AM

Gerald Childress

Austin Jonas

No

ethnicity

gender

ssn

badge

Black

Male

1871

No

Job Classification

Union Member?

Apprentice?

Period

HVAC Service Technician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/16/2018

05/15/2018

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Wrench

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

Installation, lean up, filters, fire caulk app

No

1.00

HVAC

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature