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

06/26/2018 11:08 AM

Saul Hernandez

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

3592

No

Job Classification

Union Member?

Apprentice?

Period

Asbestos Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/14/2018

06/25/2018

9.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Dozer

Crane

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

Nonw

2.00

Aerial Boomlift/forklift etc

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature