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

08/23/2019 11:45 AM

Wilfredo lima

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Insulator-Building

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/12/2019

08/22/2019

8.00

15.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Hand Tools

Clamps

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

12.00

Boom scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature