Worker Interview - DSA

Worker Interview

General Information

Project Name: Dowling Middle School (Lawson) - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: Memco, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/24/2018 02:14 PM

Ray Mosley

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Black

Male

8627

Yes

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/01/2017

01/23/2018

10.00

10.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Scraper

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

36.00

Other Work?

Other Training?

Experience

Certifications

None

None

15.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature