Worker Interview - DSA

Worker Interview

General Information

Project Name: Parker Elementary School - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: Cryer Plastering Company

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/01/2017 09:11 AM

John C persons

Victor Bowen

None

ethnicity

gender

ssn

badge

White

Male

9007

No

Job Classification

Union Member?

Apprentice?

Period

Plasterer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/17/2017

11/30/2017

8.00

19.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Snips

Drills

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

22.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature