Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: LSM Mechanical

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/09/2019 01:54 PM

David Saucedo

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

3055

No

Job Classification

Union Member?

Apprentice?

Period

Sheetmetal Worker-Ductwork

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/14/2019

10/08/2019

8.00

12.75

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Snips

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

24.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature