Worker Interview - DSA

Worker Interview

General Information

Project Name: Wilson Montessori School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Joslin Construction

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/26/2018 11:40 AM

Antonio Benitez

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

6576

No

Job Classification

Union Member?

Apprentice?

Period

Equipment Operator-Heavy Equip

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/22/2018

01/25/2018

10.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Hammer

Backhoe

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Track hoe

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature