Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Concrete Color Systems

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/16/2019 02:48 PM

Cello Arellano

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

9236

No

Job Classification

Union Member?

Apprentice?

Period

Floor Layer/Finisher

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/14/2019

05/15/2019

11.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Hand Tools

Hand Tools

vaccuum

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

7.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature