Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Greco Structures, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/13/2019 01:30 PM

Juan carlos

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Carpenter-Trim & Finish

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/01/2019

08/12/2019

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Knife

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

48.00

Other Work?

Other Training?

Experience

Certifications

None

None

1.00

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature