Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: City Masonry Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/26/2018 02:45 PM

Marco Guzman

Austin Jonas

None

ethnicity

gender

ssn

badge

Hispanic

Male

8226

No

Job Classification

Union Member?

Apprentice?

Period

Bricklayer/Stone Mason

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/12/2018

07/25/2018

8.00

26.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Scaffold

Hammer

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

30.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature