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

Jose De la Cruz

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

8395

No

Job Classification

Union Member?

Apprentice?

Period

Plumber Helper

Yes

Yes

4

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/01/2017

08/16/2017

8.00

24.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-30

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

Yes

46.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

Boomlift, scissor lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature