Worker Interview - DSA

Worker Interview

General Information

Project Name: Worthing High School (Phase II) - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: Texas Bradshaw Plumbing

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/06/2018 03:00 PM

Steven livas

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

9793

No

Job Classification

Union Member?

Apprentice?

Period

Plumber Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/14/2018

02/02/2018

8.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Knife

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

46.00

Other Work?

Other Training?

Experience

Certifications

None

None

25.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature