Worker Interview - DSA

Worker Interview

General Information

Project Name: HSPVA - HISD

Prime Contractor: McCarthy Building Company

Subcontrctor: Peak Roofing, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/18/2017 12:00 AM

Jovany Arambula

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

2813

No

Job Classification

Union Member?

Apprentice?

Period

Roofer

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/17/2017

07/11/2017

10.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Knife

Screw Gun

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

6.00

Boom

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature