Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: PFP Abatement Group

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/21/2018 01:25 PM

Rafael Pineda

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1826

No

Job Classification

Union Member?

Apprentice?

Period

Asbestos Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/02/2018

09/20/2018

6.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Hammer

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

54.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature