Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Kilgore Industries

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/30/2019 02:21 PM

Rene Alvarez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

7317

No

Job Classification

Union Member?

Apprentice?

Period

HVAC Installer/Mechanic

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/27/2019

04/29/2019

8.00

24.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Knife

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

16.00

Load scissor fork

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature