Worker Interview - DSA

Worker Interview

General Information

Project Name: Parker Elementary School - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: Trio Star Glass

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/06/2017 12:00 AM

Mike Torres

Lionel Blackwell

0

ethnicity

gender

ssn

badge

White

Male

1059

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/02/2017

11/05/2017

9.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Clamps

Tape Measure

Saw Saw

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

74.00

Other Work?

Other Training?

Experience

Certifications

0

0

18.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature