Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: FGH Insulation Co

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/28/2017 12:00 AM

Craig Grain

Victor Bowen

Sub of CFI

ethnicity

gender

ssn

badge

White

Male

1091

Yes

Job Classification

Union Member?

Apprentice?

Period

HVAC Installer/Mechanic

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/14/2017

07/27/2017

8.00

34.53

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Tape Measure

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

48.00

Other Work?

Other Training?

Experience

Certifications

None

None

35.00

Scissor, fall

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature