Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Precision Demolition, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/16/2019 10:59 AM

Damien Adams

Victor Bowen

None

ethnicity

gender

ssn

badge

Black

Male

9179

No

Job Classification

Union Member?

Apprentice?

Period

Asbestos Worker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/05/2019

07/15/2019

10.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Hammer

Power Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

46.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature