Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: Pinnacle Tile & Flooring, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/19/2018 10:24 AM

Jose vagas

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

8754

No

Job Classification

Union Member?

Apprentice?

Period

Tile Setter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/15/2018

07/18/2018

10.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Tape Measure

Trowel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

50.00

Other Work?

Other Training?

Experience

Certifications

None

None

15.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature