Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Summers Drywall Services

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/16/2017 12:00 AM

Nelson mayorga

Victor Bowen

No ot pay

ethnicity

gender

ssn

badge

Hispanic

Male

1988

No

Job Classification

Union Member?

Apprentice?

Period

Drywall Hanger

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/15/2017

10/14/2017

8.00

13.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Saw Saw

Level

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

51.00

Other Work?

Other Training?

Experience

Certifications

0

0

1.00

0

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature