Worker Interview - DSA

Worker Interview

General Information

Project Name: Worthing High School (Phase II) - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: Texas Premier Drywall Systems, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/28/2017 01:07 PM

Freddy Rivas

Victor Bowen

no OT pay

ethnicity

gender

ssn

badge

Hispanic

Female

1234

No

Job Classification

Union Member?

Apprentice?

Period

Drywall Hanger

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/20/2017

11/27/2017

10.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Snips

Hammer

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

50.00

Other Work?

Other Training?

Experience

Certifications

0

0

0.00

0

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature