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

10/17/2019 02:20 PM

Pablo Flores

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

8482

Yes

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/01/2019

10/16/2019

8.00

24.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

0.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature