Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Architectural Floors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/20/2018 10:22 AM

Jose Hernandez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

5736

No

Job Classification

Union Member?

Apprentice?

Period

Floor Layer/Finisher

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/20/2018

08/20/2018

9.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Saturday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Hammer

Broom

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

25.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature