Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Plumbing Works of Houston, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/29/2019 12:00 PM

Anthony Reyes

Lionel Blackwell

None

ethnicity

gender

ssn

badge

White

Male

4450

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/01/2017

03/28/2019

26.00

8.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Level

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

37.00

Scissor lift, boom lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature