Worker Interview - DSA

Worker Interview

General Information

Project Name: Parker Elementary School - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: Hondor Sitework and Utilities, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/06/2018 11:22 AM

Ramon Mosqueda

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

3896

No

Job Classification

Union Member?

Apprentice?

Period

Equipment Operator-Heavy Equip

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/05/2018

11/06/2018

3.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Broom

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Operator license

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature