Worker Interview - DSA

Worker Interview

General Information

Project Name: Sharpstown High School - HISD

Prime Contractor: ICI Construction

Subcontrctor: Jarrar & Company Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/12/2017 12:00 AM

Mike Campbell

Jorje Munoz

None

ethnicity

gender

ssn

badge

White

Male

2047

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/23/2017

09/11/2017

8.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Saw Saw

Cutting Torch

Wrench

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

20.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature