Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Pepper-Lawson Construction

Subcontrctor: KenMor Electric Company, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

11/09/2017 12:00 AM

Felipe Bautista

Victor Bowen

0

ethnicity

gender

ssn

badge

Hispanic

Male

8849

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/03/2017

11/08/2017

9.00

23.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hand Tools

Tape Measure

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

0

0

20.00

Excavation

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature