Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Texas A&M

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/26/2019 03:06 PM

Emilio Gutierrez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/25/2019

06/25/2019

10.00

12.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Hand Tools

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

55.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

scissor dozer backhoe excavator

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature