Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Choate USA

Interview Detail

Date

Worker Name

Auditor Name

Remarks

09/12/2019 01:53 PM

Jose Manuel Soto

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Landscape Laborer Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/02/2019

09/06/2019

8.00

13.40

Pay Type

Pay Day

deductions

OSHA

Paycheck

Tuesday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Shovel

Hammer

Wrench

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

Yes

43.00

Other Work?

Other Training?

Experience

Certifications

None

None

6.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature