Worker Interview - DSA

Worker Interview

General Information

Project Name: Madison High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Destin Drywall & Paint, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/20/2018 03:20 PM

Santos Valadez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&246

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/03/2018

09/19/2018

10.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Roller

Paint brush

Roller

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

60.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature