Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: AVAdek

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/24/2018 02:36 PM

Edgar Viera

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

8987

No

Job Classification

Union Member?

Apprentice?

Period

Metal Building Assembler

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/01/2018

09/07/2018

8.00

16.60

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Drills

Saw Saw

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature