Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: CFI Mechanical Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/19/2018 11:52 AM

Darryl Johnson

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Black

Male

6367

No

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/13/2018

09/28/2018

8.00

34.13

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

36.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature