Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Raven Mechanical LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/13/2017 12:00 AM

Abel Avalos

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

5142

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/15/2017

07/12/2018

8.00

17.00

Pay Type

Pay Day

deductions

OSHA

Debit

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Channel Locks

Ladder

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

11.00

Boom,scissor,

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature