Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Grant Mackay Company, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/30/2018 03:24 PM

Timothy timmons

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

2845

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/27/2018

04/29/2018

10.00

22.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Scissor Lift

Dozer

Excavator

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

30.00

Other Work?

Other Training?

Experience

Certifications

None

None

21.00

Excavation scissor fork rigg

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature