Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Destin Drywall & Paint, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/29/2018 02:49 PM

Adrian Luna

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Sheetmetal Worker-General

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/01/2018

05/25/2018

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Tape Measure

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

No

None

2.00

No

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature