Worker Interview - DSA

Worker Interview

General Information

Project Name: Dowling Middle School (Lawson) - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: MH Brothers, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/18/2017 12:00 AM

Javier Jimenez

Lionel Blackwell

Worked 57 hours no OT

ethnicity

gender

ssn

badge

Hispanic

Male

1082

Yes

Job Classification

Union Member?

Apprentice?

Period

Roofer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2017

09/15/2017

10.00

13.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Saturday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Tape Measure

Hand Tools

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

57.00

Other Work?

Other Training?

Experience

Certifications

0

0

5.00

Fork,boom lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature