Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: ARC Abatement Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/23/2019 10:44 AM

Jaime valdivia

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No Response

Job Classification

Union Member?

Apprentice?

Period

Laborer-Unskilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/15/2019

07/22/2019

10.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Broom

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

52.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

None

Aware of Postings?

Threatened?

No

No Response

Signatures

Employee Signature

Auditor Signature