Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Correct Electric

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/11/2018 02:23 PM

Raul Clara

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

3887

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

No

Yes

3

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/18/2018

07/10/2018

8.00

10.20

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Level

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature