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

09/26/2019 02:56 PM

Bobby Agiannidis

Gabriela Uribe

None

ethnicity

gender

ssn

badge

White

Male

7246

No

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/01/2019

09/25/2019

8.00

32.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Pipe Cutter

Wrench

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

45.00

Scissor lift. Forklift. Boomlift.

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature