Worker Interview - DSA

Worker Interview

General Information

Project Name: Austin High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: Marton Roofing Industries, Ltd.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/19/2019 11:36 AM

Hector Garcia

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Roofer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/16/2019

11/18/2019

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Hand Tools

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

37.00

Other Work?

Other Training?

Experience

Certifications

None

None

12.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature