Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: MAA Mechanical Services

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/28/2018 10:55 AM

Ricardo Guerrero

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&425

No

Job Classification

Union Member?

Apprentice?

Period

Insulator-Piping

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/01/2017

02/27/2018

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Staple Gun

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

20.00

Scissor lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature