Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Jim Hoffman Tile, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/08/2018 09:55 AM

Tri Nguyen

Victor Bowen

Paid 2 per foot

ethnicity

gender

ssn

badge

Asian

Male

7795

No

Job Classification

Union Member?

Apprentice?

Period

Tile Setter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/30/2018

08/07/2018

8.00

2.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Knife

Scraper

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

No

Yes

Signatures

Employee Signature

Auditor Signature