Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Gonzales Commercial Electric

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/25/2018 11:33 AM

Luis Lopez

Jorje Munoz

Paid biweekly

ethnicity

gender

ssn

badge

Hispanic

Male

6291

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2017

01/24/2018

10.00

20.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Drills

Screwdriver

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

13.00

Boomlift and scissor lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature