Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: CFI Mechanical Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/08/2019 11:33 AM

Brandon Sanchez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

8614

No

Job Classification

Union Member?

Apprentice?

Period

Plumber Helper

No

Yes

1

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/07/2019

08/07/2019

8.00

19.56

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Scissor lift boom lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature