Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: AVAdek

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/24/2018 01:22 PM

Jose Juan Jimenez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

6512

No

Job Classification

Union Member?

Apprentice?

Period

Metal Building Assembler

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/24/2018

07/24/2018

10.00

19.25

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Drills

Screwdriver

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature