Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Dominion Controls

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/25/2018 11:48 AM

Andres Sanchez

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

6809

No

Job Classification

Union Member?

Apprentice?

Period

HVAC Installer/Mechanic

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/01/2017

01/24/2018

17.50

17.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Level

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

15.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature