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

06/13/2018 10:15 AM

Roberto Carrizales

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

9087

No

Job Classification

Union Member?

Apprentice?

Period

Sheetmetal Worker-Roofing

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/10/2018

06/12/2018

18.00

21.00

Pay Type

Pay Day

deductions

OSHA

Debit

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Power Tools

Hand Tools

Boom Lift

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

12.00

Boom lift, forklift, shot gun, etc.

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature