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 11:47 AM

Jose Martinez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

4880

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Finisher/Cement Mason

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/01/2018

03/15/2019

8.00

22.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Shovel

Tape Measure

none

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

9.00

Other Work?

Other Training?

Experience

Certifications

None

None

30.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature