Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Gulf Coast Precast Erectors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/19/2018 03:01 PM

Diego Gomez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Ironworker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/11/2018

09/18/2018

8.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Cable Slings

Hand Tools

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

36.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

Boom fork

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature