Worker Interview - DSA

Worker Interview

General Information

Project Name: Scarborough High School - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Texas Commercial Finishes, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/20/2017 12:00 AM

Cesar Gonzalez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/30/2017

07/19/2017

10.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Roller

Paint brush

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

48.00

Other Work?

Other Training?

Experience

Certifications

None

None

15.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature