Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Bamex Painting, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/27/2018 03:03 PM

Jose Martinez

Jorje Munoz

Paid biweekly

ethnicity

gender

ssn

badge

Hispanic

Male

7648

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/20/2018

04/26/2017

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Paint brush

Roller

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

8.00

Other Work?

Other Training?

Experience

Certifications

None

None

8.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature