Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Alexjer Communications Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/02/2018 09:16 AM

Alfonso Ramirez

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/29/2018

06/29/2018

9.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Knife

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

9.00

Other Work?

Other Training?

Experience

Certifications

None

None

8.00

Boom lift, forklift, etc

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature