Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Harrrison Alarm Service

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/20/2018 10:26 AM

Ross Holloway

Victor Bowen

None

ethnicity

gender

ssn

badge

White

Male

5099

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/12/2018

06/19/2018

8.00

10.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Knife

Channel Locks

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Scissor

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature