Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: TAS Commercial Concrete Construction, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/17/2019 03:35 PM

Milson Hernandez

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

8126

No

Job Classification

Union Member?

Apprentice?

Period

Concrete Finisher/Cement Mason

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/12/2019

07/16/2019

10.00

19.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Grinder

Trowel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

15.00

Other Work?

Other Training?

Experience

Certifications

None

None

13.00

Boomlift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature