Worker Interview - DSA

Worker Interview

General Information

Project Name: Jordan High School - HISD

Prime Contractor: Cadence McShane Construction

Subcontrctor: Design Security Controls LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/19/2018 01:58 PM

Christian Yoder

Jorje Munoz

None

ethnicity

gender

ssn

badge

White

Male

5915

No

Job Classification

Union Member?

Apprentice?

Period

Electronic Data

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/16/2018

04/18/2018

9.00

25.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Wire Brush

Channel Locks

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

13.00

Ladder safety

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature