Worker Interview - DSA

Worker Interview

General Information

Project Name: Madison High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: Jomar Electrical Contractors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/27/2018 11:02 AM

Jose Sosa

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

=CHAR(048)&858

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/01/2017

02/26/2018

8.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Channel Locks

Screwdriver

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

10.00

Ladder safety

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature