Worker Interview - DSA

Worker Interview

General Information

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

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Raven Mechanical LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/12/2017 11:05 AM

Aaron Villafana

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&883

Yes

Job Classification

Union Member?

Apprentice?

Period

Plumber Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/16/2017

12/11/2017

8.00

13.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

0.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature