Worker Interview - DSA

Worker Interview

General Information

Project Name: Washington High School - HISD

Prime Contractor: Prime Contractors Inc

Subcontrctor: RTE Flooring

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/13/2018 11:23 AM

Misael Andrade

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

2915

No

Job Classification

Union Member?

Apprentice?

Period

Floor Layer/Finisher

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/02/2018

04/12/2018

4.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Knife

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

8.00

Other Work?

Other Training?

Experience

Certifications

None

None

20.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature