Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: KenMor Electric Company, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/05/2019 12:38 PM

Jason Gonzalez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

8019

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

No

Yes

4

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/21/2018

02/04/2019

8.00

20.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Drills

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

Boom scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature