Worker Interview - DSA

Worker Interview

General Information

Project Name: Askew Elementary School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Diversified Thermal, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/21/2017 12:00 AM

Raul Ibarra

Lionel Blackwell

0

ethnicity

gender

ssn

badge

Hispanic

Male

1464

No

Job Classification

Union Member?

Apprentice?

Period

Roofer

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/28/2017

07/20/2017

8.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Channel Locks

Tape Measure

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

0

0

20.00

0

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature