Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: PFP Abatement Group

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/27/2018 01:34 PM

Acxel Diaz

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

4501

No

Job Classification

Union Member?

Apprentice?

Period

Asbestos Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/06/2018

06/26/2018

10.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Hammer

Scraper

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

60.00

Other Work?

Other Training?

Experience

Certifications

Foreman

None

8.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature