Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: JMR

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/31/2019 01:45 PM

Jeff land

Victor Bowen

None

ethnicity

gender

ssn

badge

White

Male

4723

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/30/2019

10/25/2019

8.00

27.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Knife

Hand Tools

Channel Locks

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

24.00

Other Work?

Other Training?

Experience

Certifications

None

None

35.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature