Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: S Thomas Construction LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/06/2019 01:04 PM

Emilio Cruz

Lionel Blackwell

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

06/03/2019

06/04/2019

10.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Tape Measure

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Loader and bobcat

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature