Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Momentum Exterior Systems, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/26/2019 03:02 PM

Jose carreno

Gabriela Uribe

None

ethnicity

gender

ssn

badge

Hispanic

Male

3156

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2019

09/25/2019

8.00

25.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hammer

Blueprints

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

No

None

8.00

Boomlift. Forklift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature