Worker Interview - DSA

Worker Interview

General Information

Project Name: North Forest High School - HISD

Prime Contractor: B3Ci (JV BETWEEN BALFOUR BEATTY & 3Ci CONSTRUCTION)

Subcontrctor: Door Components LP dba Door Pro Systems

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/26/2017 12:00 AM

John Landers

Victor Bowen

0

ethnicity

gender

ssn

badge

White

Male

1829

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/01/2017

10/25/2017

8.00

12.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Bandsaw

Power Tools

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

36.00

Other Work?

Other Training?

Experience

Certifications

0

0

4.00

0

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature