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

06/19/2019 09:50 AM

Omar Rodriguez

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

6541

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

06/18/2019

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Boomlift and scissor lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature