Worker Interview - DSA

Worker Interview

General Information

Project Name: YWCPA - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: 1 Priority Environmental Services, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/04/2018 11:17 AM

Lucio toto

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

9216

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/10/2017

01/03/2017

10.00

16.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Knife

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

21.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature