Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Diversified Thermal, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/08/2019 11:27 AM

Trinidad flores

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

7641

No

Job Classification

Union Member?

Apprentice?

Period

Waterproofer/Caulker

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/02/2019

09/16/2019

8.00

22.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Tape Measure

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

15.00

Fork scissor boom

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature