Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Memco, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/08/2019 11:15 AM

Jimmy crow

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

9511

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/08/2019

08/08/2019

0.00

11.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Knife

Shovel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

30.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature