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

01/05/2018 03:21 PM

Roger Simon

Lionel Blackwell

None

ethnicity

gender

ssn

badge

White

Male

=CHAR(048)&419

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

Yes

2

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/03/2018

01/04/2018

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Tape Measure

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature