Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Anchor fences

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/04/2019 01:49 PM

Mamma Jackson

Lionel Blackwell

None Jammaca his first name

ethnicity

gender

ssn

badge

Black

Male

1464

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/01/2019

10/03/2019

9.50

12.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Drills

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

Bobcat, loader,

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature