Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Accurate Glass Systems of Texas, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/31/2018 01:50 PM

Noel casarez

Victor Bowen

Pwi

ethnicity

gender

ssn

badge

Hispanic

Male

5670

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/02/2018

10/30/2018

8.00

13.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Drills

Tape Measure

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

45.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Fork scissor man lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature