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

01/26/2018 02:28 PM

Jorge A Rodriguez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&918

No

Job Classification

Union Member?

Apprentice?

Period

Plumber Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/22/2018

01/25/2018

8.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Hand Tools

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

17.00

Fork

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature