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

Alberto Escalante

Lionel Blackwell

0

ethnicity

gender

ssn

badge

Hispanic

Male

7016

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/01/2017

10/05/2017

9.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Roller

Tape Measure

Knife

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

0

0

30.00

Scissor lift

Aware of Postings?

Threatened?

Yes

Yes

Signatures

Employee Signature

Auditor Signature