Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: D & H Masonry, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/29/2018 10:24 AM

Roberto Navarro

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/01/2018

05/25/2018

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Hammer

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

No

None

10.00

No

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature