Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: CFI Mechanical Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/17/2017 12:00 AM

James Johnson

Lionel Blackwell

0

ethnicity

gender

ssn

badge

White

Male

4814

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2017

08/16/2017

8.00

34.35

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Level

Channel Locks

Wrench

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

0

0

21.00

Scissor lift, load

Aware of Postings?

Threatened?

Yes

Yes

Signatures

Employee Signature

Auditor Signature