Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Gulf Star Roofing and Sheetmetal

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/10/2019 11:40 AM

William A zelaya

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&997

No

Job Classification

Union Member?

Apprentice?

Period

Roofer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/26/2019

10/09/2019

10.00

23.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Boom Lift

Knife

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

30.00

Other Work?

Other Training?

Experience

Certifications

None

None

26.00

Boom fork

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature