Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Diversified Thermal, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/12/2019 11:19 AM

Juan Garcia

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

5646

No

Job Classification

Union Member?

Apprentice?

Period

Insulator-Building

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/01/2019

06/11/2019

8.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Broom

Scraper

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Scissor lift, ladder and boomlift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature