Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Milam & Co. Painting, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/17/2019 01:03 PM

Sergio Flores

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Painter

Unkown

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/05/2018

11/07/2018

8.00

15.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Hammer

Paint brush

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

35.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature