Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: Prime Contractors Inc

Subcontrctor: Cryer Plastering Company

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/09/2018 11:24 AM

Johnathon Rodriguez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

9730

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/16/2018

08/03/2018

8.00

11.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Trowel

Knife

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

7.00

Lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature