Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: TX Lonestar Mechanical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/05/2018 02:19 PM

Jose Carlos Villatoro

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

7990

No

Job Classification

Union Member?

Apprentice?

Period

Insulator-Piping

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/14/2018

04/04/2018

10.00

24.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Wire Brush

Drills

Saw Saw

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

4.00

Other Work?

Other Training?

Experience

Certifications

None

None

14.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature