Worker Interview - DSA

Worker Interview

General Information

Project Name: Askew Elementary School - HISD

Prime Contractor: Drymalla Construction Co. Inc.

Subcontrctor: Choate USA

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/23/2018 01:16 PM

Victor Molina

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Landscape Laborer Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/23/2018

02/23/2018

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Tuesday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Broom

Shovel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature