Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Winco Masonry

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/24/2019 10:42 AM

Raul Garcia

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Bricklayer Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/01/2018

10/22/2019

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Shovel

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

22.00

Scaffold certificate

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature