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 01:36 PM

Jacobo mendez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1376

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/04/2018

06/26/2018

10.00

12.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Hammer

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

50.00

Other Work?

Other Training?

Experience

Certifications

None

None

1.00

Scissor boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature