Worker Interview - DSA

Worker Interview

General Information

Project Name: Sam Houston High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Texas Saffire, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/10/2018 02:22 PM

Raymond Anzaldua

Lionel Blackwell

Wage problem

ethnicity

gender

ssn

badge

Hispanic

Male

4568

No

Job Classification

Union Member?

Apprentice?

Period

Sprinkler Fitter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/01/2017

01/09/2018

10.00

19.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Level

Channel Locks

Wrench

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

14.00

scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature