Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Correct Electric

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/18/2017 12:00 AM

Luis Flores

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

8648

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

Yes

Yes

4

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/14/2017

07/14/2017

40.00

21.80

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hammer

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

8.00

Scissor, arial

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature