Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Meredith Environmental, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/07/2018 12:16 PM

Ramon Zaballa

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

4958

No

Job Classification

Union Member?

Apprentice?

Period

Asbestos Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/01/2018

06/06/2018

10.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hand Tools

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

45.00

Other Work?

Other Training?

Experience

Certifications

None

None

20.00

Asbestos

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature