Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: EVYS Electric, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/02/2018 10:17 AM

Jose Guerrero

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

2849

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

No

Yes

2

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/01/2017

05/01/2018

8.00

17.80

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Level

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature