Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: Steel Masters, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/25/2018 02:19 PM

Primitivo Negrete

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Ironworker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/01/2017

01/24/2018

8.00

17.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Bull pin, wrench

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

34.00

Other Work?

Other Training?

Experience

Certifications

None

None

6.00

Scissor lift, forklift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature