Worker Interview - DSA

Worker Interview

General Information

Project Name: Askew Elementary School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Unique Plumbing Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/02/2018 11:35 AM

Chris Scully

Lionel Blackwell

None

ethnicity

gender

ssn

badge

White

Male

2027

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/01/2018

02/01/2018

8.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Drills

Test Lamps

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

0.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature