Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Northstar Demolition and Remediation, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/07/2017 12:00 AM

Eddie zarate

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

2875

No

Job Classification

Union Member?

Apprentice?

Period

Equipment Operator-Heavy Equip

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/03/2017

07/06/2017

8.00

26.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Dozer

Heavy Loaders

Excavator

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

No

None

35.00

Heavy Equipment

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature