Worker Interview - DSA

Worker Interview

General Information

Project Name: Madison High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Greco Structures, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/19/2019 11:34 AM

Fabian Gomez

Jorje Munoz

Name is Favian

ethnicity

gender

ssn

badge

Hispanic

Male

9591

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Finisher/Cement Mason

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/14/2019

03/18/2019

10.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Level

Trowel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

26.00

Other Work?

Other Training?

Experience

Certifications

None

None

37.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature