Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: Mod U Serve

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/14/2018 11:00 AM

Miguel angel martinez

Victor Bowen

Paid per day weekly

ethnicity

gender

ssn

badge

Hispanic

Male

6588

No

Job Classification

Union Member?

Apprentice?

Period

Tile Setter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/14/2018

03/14/2018

0.00

0.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Level

Grinder

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

20.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature