Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: D & H Masonry, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/01/2019 02:18 PM

Alexander martinez

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Bricklayer Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/29/2019

04/30/2019

8.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Knife

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

1

1.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature