Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Letsos Company

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/02/2019 01:33 PM

Andrew Stasny

Jorje Munoz

None

ethnicity

gender

ssn

badge

White

Male

8857

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2018

05/01/2019

8.00

35.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Bandsaw

Channel Locks

Screwdriver

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

6.00

Scissor lift and boomlift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature