Worker Interview - DSA

Worker Interview

General Information

Project Name: Wharton K-8 Dual Language Academy - HISD

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: K & S Contracting, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/02/2018 10:09 AM

David Mendoza

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

6488

No

Job Classification

Union Member?

Apprentice?

Period

Landscape Laborer Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/30/2018

05/01/2018

8.00

13.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Screwdriver

Paint brush

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

8.00

Other Work?

Other Training?

Experience

Certifications

None

None

0.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature