Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Hou-Tex Newnom Inc., dba Hou-Tex Glass & Mirror

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/25/2018 11:29 AM

Ricardo Vargas

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&121

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/01/2017

01/24/2018

8.00

23.20

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hammer

Pry bar

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

36.00

Other Work?

Other Training?

Experience

Certifications

None

None

11.00

Boomlift and scissor lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature