Worker Interview - DSA

Worker Interview

General Information

Project Name: Worthing High School (Phase II) - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: T. Bradshaw Plumbing

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/13/2017 12:00 AM

Tamil Muhammad

Lionel Blackwell

0

ethnicity

gender

ssn

badge

Black

Male

1084

No

Job Classification

Union Member?

Apprentice?

Period

Plumber Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/01/2017

09/12/2017

8.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Level

Channel Locks

Tape Measure

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

13.00

Other Work?

Other Training?

Experience

Certifications

0

0

17.00

Scissor,fork lift

Aware of Postings?

Threatened?

Yes

Yes

Signatures

Employee Signature

Auditor Signature