Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: TAS Commercial Concrete Construction, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/27/2017 12:00 AM

David Silva

Victor Bowen

0

ethnicity

gender

ssn

badge

Hispanic

Male

8544

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/06/2017

09/26/2017

10.00

23.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Hand Tools

Knife

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

50.00

Other Work?

Other Training?

Experience

Certifications

No

0

11.00

Rigging forklift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature