Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: AVAdek

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/17/2019 03:19 PM

Jerson carmona

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

4320

No

Job Classification

Union Member?

Apprentice?

Period

Metal Building Assembler

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/15/2019

07/16/2019

1.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Power Tools

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature