Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: CLS Technology, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/22/2019 01:47 PM

Nathan Chance

Lionel Blackwell

None

ethnicity

gender

ssn

badge

White

Male

1550

Yes

Job Classification

Union Member?

Apprentice?

Period

Electronic Data

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/12/2019

08/21/2019

10.00

22.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

42.00

Other Work?

Other Training?

Experience

Certifications

None

None

29.00

Fork lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature