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

06/19/2019 09:39 AM

Carl rodriguez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

2050

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/04/2019

06/18/2019

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Drills

Forklift

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

Fork scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature