Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: D & H Masonry, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/03/2019 03:05 PM

Enrique Guzman

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Bricklayer Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/02/2019

10/02/2019

8.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Hand Tools

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

37.00

Other Work?

Other Training?

Experience

Certifications

None

None

13.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature