Worker Interview - DSA

Worker Interview

General Information

Project Name: Yates High School - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: Jimerson Underground, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/06/2019 12:52 PM

Antonio Lopez

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

Yes

Job Classification

Union Member?

Apprentice?

Period

Pipe Layer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/15/2019

03/05/2019

10.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Hammer

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

30.00

Other Work?

Other Training?

Experience

Certifications

None

None

18.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature