Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: Humphrey Company, Ltd

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/19/2018 01:57 PM

Gerardo Hernandez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

2525

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

Yes

Yes

4

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/01/2018

04/18/2018

8.00

25.30

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Clamps

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

42.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature