Worker Interview - DSA

Worker Interview

General Information

Project Name: Worthing High School (Phase II) - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: T. Bradshaw Plumbing

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/12/2017 12:00 AM

Charles Bradley

Lionel Blackwell

O

ethnicity

gender

ssn

badge

Black

Male

8256

Yes

Job Classification

Union Member?

Apprentice?

Period

Plumber

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/19/2017

07/11/2017

7.50

25.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Welding torch

Channel Locks

Pipe Cutter

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

37.00

Other Work?

Other Training?

Experience

Certifications

0

0

20.00

0

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature