Worker Interview - DSA

Worker Interview

General Information

Project Name: Sharpstown High School - HISD

Prime Contractor: ICI Construction

Subcontrctor: Texas Premier Drywall Systems, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/10/2017 12:00 AM

Jorge Rodriguez

Yolanda Gaines

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Drywall-Tape & Float

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/07/2017

08/09/2017

10.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Spatula

Roller

Floats

Hanger

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

16.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature