Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: Winco Masonry

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/27/2017 12:00 AM

William Robinson

Victor Bowen

0

ethnicity

gender

ssn

badge

White

Male

5392

No

Job Classification

Union Member?

Apprentice?

Period

Bricklayer/Stone Mason

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/15/2017

10/26/2017

8.00

25.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Power Tools

Hammer

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

0

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature