Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: Prime Contractors Inc

Subcontrctor: Texas Saffire, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/12/2017 12:00 AM

Jose Guerra

Victor Bowen

Name is Josue

ethnicity

gender

ssn

badge

Hispanic

Male

1688

Yes

Job Classification

Union Member?

Apprentice?

Period

Laborer-Unskilled

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/26/2017

06/27/2017

10.00

10.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Drills

Drills

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

1.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature