Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Window Systems of Texas

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/09/2019 11:34 AM

Jose Martinez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

7459

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/14/2018

01/08/2019

18.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Drills

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

6.00

Boom scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature