Worker Interview - DSA

Worker Interview

General Information

Project Name: Wharton K-8 Dual Language Academy - HISD

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Empire Steel Erectors LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/30/2017 12:00 AM

Jose M Mendoza

Victor Bowen

0

ethnicity

gender

ssn

badge

Hispanic

Male

3111

No

Job Classification

Union Member?

Apprentice?

Period

Ironworker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/26/2017

10/27/2017

8.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Power Tools

Welding torch

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

16.00

Other Work?

Other Training?

Experience

Certifications

0

0

23.00

Scissor boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature