Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Oxford Builders Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/15/2019 03:19 PM

Franklin m verdezoto

Victor Bowen

Informed me he was salary after the interview.

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Carpenter-Form

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/15/2018

12/15/2018

8.00

0.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hammer

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

14.00

Scissor boom fork

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature