Worker Interview - DSA

Worker Interview

General Information

Project Name: Davis (Northside) High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: J.R. Jones Roofing

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/05/2018 11:51 AM

Luis bonilla

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

11234

No

Job Classification

Union Member?

Apprentice?

Period

Roofer

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/22/2018

04/04/2018

8.00

24.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Level

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

36.00

Other Work?

Other Training?

Experience

Certifications

None

None

17.00

Scaffold

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature