Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Duty Construction, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/18/2018 01:08 PM

Daniel Resendiz

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1830

No

Job Classification

Union Member?

Apprentice?

Period

Equipment Operator-Heavy Equip

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/02/2018

08/01/2018

8.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Tape Measure

Shovel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

31.00

Other Work?

Other Training?

Experience

Certifications

None

None

25.00

Tracho

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature