Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Radley Staffing

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/05/2017 12:00 AM

Michael lewis

Victor Bowen

0

ethnicity

gender

ssn

badge

Black

Male

7716

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/02/2017

10/04/2017

10.00

10.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Hand Tools

Hand Tools

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

0

0

1.00

Fork scissor, boom

Aware of Postings?

Threatened?

No

Yes

Signatures

Employee Signature

Auditor Signature