Worker Interview - DSA

Worker Interview

General Information

Project Name: Westbury High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Marek Brothers

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/01/2018 02:53 PM

Jesus Salazar

Jorje Munoz

Paid cash

ethnicity

gender

ssn

badge

Hispanic

Male

6271

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/08/2018

01/31/2018

8.00

12.00

Pay Type

Pay Day

deductions

OSHA

Cash

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Scraper

Broom

Roller

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

Yes

45.00

Other Work?

Other Training?

Experience

Certifications

None

None

0.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature