Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Jackson Insulation, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/20/2018 10:12 AM

Jaime Hinostroza

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1642

No

Job Classification

Union Member?

Apprentice?

Period

Insulator-Piping

No

No

7

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/08/2018

06/19/2018

8.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Tape Measure

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

7.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature