Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Tri-Star Glass

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/11/2018 01:20 PM

Andrew Munguia

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

5165

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/01/2018

05/10/2018

8.00

10.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Drills

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

66.00

Other Work?

Other Training?

Experience

Certifications

None

None

6.00

Scissor lift boom

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature