Worker Interview - DSA

Worker Interview

General Information

Project Name: Madison High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Hellas Construction, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

08/28/2019 02:02 PM

Javier Pineda

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

5240

No

Job Classification

Union Member?

Apprentice?

Period

Carpenter-Form

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/01/2019

08/27/2019

11.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Level

Shovel

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

60.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature