Worker Interview - DSA

Worker Interview

General Information

Project Name: Madison High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Jomar Electrical Contractors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/06/2018 12:04 PM

Tim Ruth

Austin Jonas

None

ethnicity

gender

ssn

badge

White

Male

=CHAR(048)&819

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

3

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/01/2018

06/05/2018

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Debit

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Power Tools

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None/in school

3.00

Scissor lift, compact,

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature