Worker Interview - DSA

Worker Interview

General Information

Project Name: Madison High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: D & H Masonry, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/08/2018 11:08 AM

Osiel Albaran

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&981

No

Job Classification

Union Member?

Apprentice?

Period

Equipment Operator-Heavy Equip

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/04/2018

05/07/2018

8.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Tape Measure

Forklift

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

17.00

Operator license

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature