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

Miguel Bonilla sr.

Lionel Blackwell

0

ethnicity

gender

ssn

badge

Hispanic

Male

4494

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/01/2017

07/21/2017

8.00

0.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Clamps

Tape Measure

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

48.00

Other Work?

Other Training?

Experience

Certifications

0

0

25.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature