Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Summers Drywall Services

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/13/2018 11:52 AM

Alfredo jimenez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

7028

No

Job Classification

Union Member?

Apprentice?

Period

Drywall Hanger

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

05/02/2018

06/12/2018

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Knife

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

28.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature