Worker Interview - DSA

Worker Interview

General Information

Project Name: Askew Elementary School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: J.R. Jones Roofing

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/25/2017 12:00 AM

Jose Orozco

Victor Bowen

No OT pay

ethnicity

gender

ssn

badge

Hispanic

Male

8268

No

Job Classification

Union Member?

Apprentice?

Period

Roofer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/08/2017

10/24/2017

9.00

19.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Drills

Hand Tools

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

45.00

Other Work?

Other Training?

Experience

Certifications

0

0

11.00

Fork

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature