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

08/23/2017 12:00 AM

Javier Chavez

Lionel Blackwell

0

ethnicity

gender

ssn

badge

Hispanic

Male

9814

Yes

Job Classification

Union Member?

Apprentice?

Period

Pipe Fitter

Yes

Yes

2

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2017

08/22/2017

8.00

20.46

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Tape Measure

Level

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

0

0

2.00

Fork lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature