Worker Interview - DSA

Worker Interview

General Information

Project Name: Scarborough High School - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Texas Commercial Finishes, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/05/2017 01:18 PM

Marvin Vasquez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/02/2017

12/04/2017

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Trowel

Knife

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

8.00

Other Work?

Other Training?

Experience

Certifications

0

0

20.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature