Worker Interview - DSA

Worker Interview

General Information

Project Name: Parker Elementary School - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: King Tile

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/06/2017 12:00 AM

Duy Nguyen

Jorje Munoz

Paid by square foot

ethnicity

gender

ssn

badge

Asian

Male

1952

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/24/2017

11/03/2017

8.00

12.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Tape Measure

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

0.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature