Worker Interview - DSA

Worker Interview

General Information

Project Name: Askew Elementary School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Building Concrete Solutions LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/25/2017 12:00 AM

Benito Longoria

Jorje Munoz

0

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Carpenter-Form

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/23/2017

10/24/2017

8.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Trowel

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

Operator

None

5.00

Operator license

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature