Worker Interview - DSA

Worker Interview

General Information

Project Name: Milby High School - HISD

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Himmel’s doors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/04/2019 12:40 PM

Erick Garcia

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

3779

No

Job Classification

Union Member?

Apprentice?

Period

Welder-Structural

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/02/2019

12/03/2019

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Tape Measure

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

1.00

Forklift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature