Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Correct Electric

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/05/2018 01:35 PM

Gerardo montealvo

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/17/2017

01/04/2018

8.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hand Tools

Saw Saw

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

15.00

Boom scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature