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 11:56 AM

Jessie Quintania

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

2338

No

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/01/2018

09/18/2018

8.00

34.17

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Level

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

28.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature