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 11:44 AM

Jose Hernan Reyna III

Victor Bowen

None

ethnicity

gender

ssn

badge

White

Male

5894

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/07/2019

08/07/2019

8.00

24.24

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Hand Tools

Power Tools

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

Fork scissor boom

Aware of Postings?

Threatened?

No Response

No

Signatures

Employee Signature

Auditor Signature