Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: The Theut Company LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/05/2018 11:15 AM

Steven Gosneol

Austin Jonas

None

ethnicity

gender

ssn

badge

White

Male

5027

No

Job Classification

Union Member?

Apprentice?

Period

Welder-Structural

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/01/2017

06/05/2018

8.00

23.80

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Saw Saw

Grinder

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

Below foreman

None

5.00

Forks, manlift, scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature