Worker Interview - DSA

Worker Interview

General Information

Project Name: Parker Elementary School - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: Summers Drywall Services

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/01/2017 09:22 AM

Carlos marquez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Drywall Hanger

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/01/2017

11/30/2017

8.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Saturday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hand Tools

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

30.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature