Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: Texas Moisture Protection Co.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/19/2018 10:07 AM

Wilman Guzman

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Waterproofer/Caulker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/10/2018

07/18/2018

10.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Caulker

Mixer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

58.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

Heavy equipment certs

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature