Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Kadex Masonry

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/19/2019 09:31 AM

Ivan Andrade

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

3730

No

Job Classification

Union Member?

Apprentice?

Period

Equipment Operator-Heavy Equip

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/14/2019

06/18/2019

9.00

19.00

Pay Type

Pay Day

deductions

OSHA

Cash

Friday

No

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

5.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature