Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Refine Concrete Services

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/17/2019 02:47 PM

Javier Ac cuc

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

3450

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Finisher/Cement Mason

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/05/2019

10/16/2019

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Trowel

Knife

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

1.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature