Worker Interview - DSA

Worker Interview

General Information

Project Name: Sharpstown High School - HISD

Prime Contractor: ICI Construction

Subcontrctor: Knu Kote Services

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/06/2017 12:00 AM

Valente Escalante

Jorje Munoz

0

ethnicity

gender

ssn

badge

Hispanic

Male

8819

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/01/2017

10/06/2017

10.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Paint brush

Roller

Spray Gun

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

48.00

Other Work?

Other Training?

Experience

Certifications

None

None

28.00

Scissor lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature