Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Rhodes Drywall & Paint

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/12/2017 01:46 PM

Miguel Taban

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

4254

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/12/2017

12/11/2017

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Paint brush

Roller

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

50.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature