Worker Interview - DSA

Worker Interview

General Information

Project Name: North Forest High School - HISD

Prime Contractor: B3Ci (JV BETWEEN BALFOUR BEATTY & 3Ci CONSTRUCTION)

Subcontrctor: BCI

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/23/2017 12:00 AM

Rigo Garcia

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

4385

No

Job Classification

Union Member?

Apprentice?

Period

Drywall-Tape & Float

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/23/2017

08/23/2017

0.00

25.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Excavator

Clam Shells

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

Yes

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

19.00

Fork scissor boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature