Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Dominion Controls

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/20/2019 01:57 PM

Roger Reyes

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

7168

No

Job Classification

Union Member?

Apprentice?

Period

HVAC Installer/Mechanic

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/23/2017

02/19/2019

10.00

19.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Hand Tools

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

25.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature