Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: Texas Premier Drywall Systems, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/10/2018 11:20 AM

Jose Martinez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

9165

No

Job Classification

Union Member?

Apprentice?

Period

Drywall-Tape & Float

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/16/2018

05/09/2018

8.00

19.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Tape Measure

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature