Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: KenMor Electric Company, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/12/2017 03:14 PM

Soo Gi kim

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Asian

Male

4656

No

Job Classification

Union Member?

Apprentice?

Period

Electronic Data

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/11/2017

12/11/2017

9.00

0.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Level

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

12.00

Boom lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature