Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: CFI Mechanical Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/25/2018 12:18 PM

Roy Gonzalez

Victor Bowen

None

ethnicity

gender

ssn

badge

White

Male

7673

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/03/2018

05/24/2018

8.00

34.90

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Level

Hand Tools

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

Scissor boom skid

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature