Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Sheffield Acoustical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/18/2017 12:00 AM

Miguel Cruz

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

8895

No

Job Classification

Union Member?

Apprentice?

Period

Ceiling Tile Installer

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/18/2017

07/18/2017

0.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Snips

Tape Measure

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

18.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature