Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Sendero Industries LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/24/2019 12:15 PM

Vivian Galvez

Jorje Munoz

Also does operator work

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/24/2019

01/24/2019

0.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Heavy Loaders

Shovel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

Operator

None

2.50

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature