Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: Chief Fire Systems, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/05/2018 02:06 PM

Maximilliano Martinez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

4241

No

Job Classification

Union Member?

Apprentice?

Period

Sprinkler Fitter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/26/2018

04/04/2018

10.00

38.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Tape Measure

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

49.00

Other Work?

Other Training?

Experience

Certifications

None

None 15

0.00

Safety meeting

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature