Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Trans Texas Tennis, LTD

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/25/2018 12:05 PM

Kevin Garcia

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/05/2018

07/24/2018

8.00

11.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Mixer

Tape Measure

Shovel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

60.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature