Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Texas A&M

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/05/2019 02:43 PM

Hector delgado

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Equipment Operator-Heavy Equip

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/15/2018

02/04/2019

9.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Dozer

Excavator

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

50.00

Other Work?

Other Training?

Experience

Certifications

None

None

12.00

Heavy equipment

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature