Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Meredith Environmental, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/07/2018 10:04 AM

Gloria Flores

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Female

1302

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/01/2018

06/06/2018

10.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Tape Measure

Channel Locks

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

27.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

Safety meeting

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature