Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: The Theut Company LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/24/2017 12:00 AM

Matthew Gomez

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

3331

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/01/2017

07/21/2017

8.00

24.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Scissor Lift

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

47.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Swing stage, boomlift, scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature