Worker Interview - DSA

Worker Interview

General Information

Project Name: Sharpstown High School - HISD

Prime Contractor: ICI Construction

Subcontrctor: Cherry Moving Co. dba Cherry Demolition

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/11/2018 12:02 PM

Trevor Harris

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Black

Male

1098

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/01/2018

06/08/2018

10.00

12.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Wrench

Shovel

Channel Locks

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

58.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

Bobcat

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature