Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Steel Masters, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/21/2018 02:40 PM

Hector alegria

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Ironworker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/14/2017

03/20/2018

8.00

23.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Hand Tools

Power Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

42.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Boom fork

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature